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General NPI Number Information
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NPI Number | 1144080326
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Entity Type | Organization
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Legal Business Name | WELLMIND VERMONT, PLLC
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Dates
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Enumeration Date | 03/22/2024
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Last Update Date | 03/30/2024
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Provider Practice Location Address
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Address Line | 186 STATE ST
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City | RUTLAND
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State | VT
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Zip | 05701-2752
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Country | US
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Telephone | 802-417-2039
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Fax | 802-209-8870
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Provider Business Mailing Address
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Address Line | 186 STATE ST
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City | RUTLAND
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State | VT
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Zip | 05701-2752
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Country | US
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Telephone | 802-417-2039
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Fax | 802-209-8870
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Authorized Official
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Title or Position | OWNER-MEMBER
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Name | MR. MICHAEL EDWARD LAWRIE JR.
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Credential | APRN
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Telephone | 802-417-2039
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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