Healthcare Provider Details

I. General information

NPI: 1528542388
Provider Name (Legal Business Name): TERESA D'MARZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERESA MARZILLI

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

539 SPRUCE HAVEN RD
WATERBURY CENTER VT
05677-8065
US

IV. Provider business mailing address

PO BOX 641
STOWE VT
05672-0641
US

V. Phone/Fax

Practice location:
  • Phone: 802-585-5437
  • Fax:
Mailing address:
  • Phone: 802-585-5437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number097.0136714
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: