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STACY PODETZ
Mental Health >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1932433729
Individual Registrant: STACY PODETZ
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
30 AIRPORT RD S BURLINGTON, VT 05403-6432 US
Tel: 802-658-0040 Fax: 802-658-0216
Tel: 802-658-0040 Fax: 802-658-0216
Contact information for business:
30 AIRPORT RD S BURLINGTON, VT 05403-6432 US
Tel: 802-658-0040 Fax: 802-658-0216
Tel: 802-658-0040 Fax: 802-658-0216
Registration Information:
NPI: 1932433729
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor Mental Health |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
