Organization
LAURIE ANNE COOMBS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURIE ANNE COOMBS LICSW (PRESIDENT)
(802) 282-1786
Entity
Organization
Contact information
Practice address
120 MERCHANTS ROW, RUTLAND, VT 05701-5911
(802) 282-1786
(802) 747-0095
Mailing address
85 DAVIS ST, RUTLAND, VT 05701-3309
(802) 282-1786
(802) 747-0095
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089.0048415
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0029313
MEDICARE PTAN
VT
05
—
1018310
—
VT
Enumeration date
04/29/2016
Last updated
04/29/2016
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