| Doctor Name: | PENNY SUE KIMBALL MACDONALD |
| NPI Number: | 1356487284 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS LADC LCMHC |
| License Number: | 000130 |
| Business Practice Address: | 1129 Main St St Johnsbury, VT - 05819 |
| Business Phone Number: | 8027488904 |
| Business Fax Number: | |
| Mailing Address: | Po Box 278, ST JOHNSBURY CENTER |
| State: | VT |
| Postal Code: | 05863 |
| Phone Number: | 8027488904 |
| Fax Number: | |
| NPI Enumeration Date: | 01/29/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 000130 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | VT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |