Individual
MS. ELISE BROKAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
67 CATAMOUNT PARK, MIDDLEBURY, VT 05753-1397
(802) 388-6751
(802) 388-8183
Mailing address
89 MAIN ST, MIDDLEBURY, VT 05753-1459
(802) 388-6751
(802) 388-8183
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0890001032
VT
Other
Enumeration date
01/07/2016
Last updated
01/07/2016
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