Individual
ANGELA J WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
560 RAILROAD ST, ST JOHNSBURY, VT 05819
(802) 748-3181
(802) 748-0704
Mailing address
53 PLEASANT ST, ST JOHNSBURY, VT 05819
(802) 274-1077
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
089-0000962
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009771
—
VT
Enumeration date
01/16/2007
Last updated
07/08/2007
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