Healthcare Provider Details

I. General information

NPI: 1053079749
Provider Name (Legal Business Name): SAINT MICHAEL SCHOOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2021
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 WALNUT ST
BRATTLEBORO VT
05301-2992
US

IV. Provider business mailing address

48 WALNUT ST
BRATTLEBORO VT
05301-2992
US

V. Phone/Fax

Practice location:
  • Phone: 802-254-6320
  • Fax:
Mailing address:
  • Phone: 802-254-6320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELAINE BEAM
Title or Position: PRINCIPAL
Credential:
Phone: 802-254-6320