Doctor Name: | MRS. BARBARA ELIZABETH VITALIS |
NPI Number: | 1073871034 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | |
Business Practice Address: | 16 Town Crier Dr Brattleboro, VT - 053018669 |
Business Phone Number: | 8022584623 |
Business Fax Number: | |
Mailing Address: | 105 Frost St, Apartment 1 BRATTLEBORO |
State: | VT |
Postal Code: | 053017187 |
Phone Number: | 8023801243 |
Fax Number: | |
NPI Enumeration Date: | 04/27/2012 |
NPI Last Update Date: | 04/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |