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NPI Code Detail

MEDICARE: MARNE STOTHART

MEDICARE: MARNE STOTHART
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor000281VT

General Provider Information

NPI Number : 1558792432
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARNE STOTHART
Provider Business Mailing Address
First Line : 208 FLYNN AVE
Second Line : SUITE 3J
City : BURLINGTON
State : VT
Zip : 05401-5429
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 75 SAN REMO DR
Second Line :
City : SOUTH BURLINGTON
State : VT
Zip : 05403-6385
Country : US
Telephone Number : 802-488-7350
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2013
Last Update Date : 12/08/2015

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Directions to “ MARNE STOTHART ” Practice Location

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