Doctor Name: | MS. MEREDITH L KENYON |
NPI Number: | 1134421928 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 089.0001054 |
Business Practice Address: | 1 Anna Marsh Lane 803 Brattleboro, VT - 05302 |
Business Phone Number: | 8022584346 |
Business Fax Number: | 8022583743 |
Mailing Address: | Box 803, 1 Anna Marsh Lane BRATTLEBORO |
State: | VT |
Postal Code: | 05302 |
Phone Number: | 8022584346 |
Fax Number: | 8022583743 |
NPI Enumeration Date: | 11/30/2010 |
NPI Last Update Date: | 11/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 089.0001054 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |