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General NPI Number Information
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NPI Number | 1356792683
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Entity Type | Organization
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Legal Business Name | TAYLOE DENTON LLC
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Dates
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Enumeration Date | 06/28/2016
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Last Update Date | 06/28/2016
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Provider Practice Location Address
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Address Line | 4 THE GRN
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City | WOODSTOCK
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State | VT
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Zip | 05091-1345
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Country | US
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Telephone | 802-291-2929
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Fax |
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Provider Business Mailing Address
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Address Line | 4 THE GRN
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City | WOODSTOCK
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State | VT
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Zip | 05091-1345
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | VIRGINIA T DENTON
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Credential |
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Telephone | 802-291-2929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0680114974
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License Number State | VT
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