Organization
VERMONT WELLNESS COLLABORATIVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYRUS PATTEN LICSW (DIRECTOR)
(802) 497-4864
Entity
Organization
Contact information
Practice address
8 PEARL ST, ESSEX JUNCTION, VT 05452-3604
(802) 497-4864
Mailing address
8 PEARL ST, ESSEX JUNCTION, VT 05452-3604
(802) 497-4864
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025959
—
VT
Enumeration date
06/18/2019
Last updated
06/18/2019
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