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General NPI Number Information
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NPI Number | 1538082284
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Entity Type | Organization
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Legal Business Name | GREEN MOUNTAIN PELVIC HEALTH
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Dates
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Enumeration Date | 07/31/2026
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Last Update Date | 07/31/2026
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Provider Practice Location Address
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Address Line | 207 MAIN ST
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City | BENNINGTON
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State | VT
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Zip | 05201-3049
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Country | US
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Telephone | 802-736-6218
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Fax | 802-277-7309
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Provider Business Mailing Address
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Address Line | 314 LAKE DR
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City | NORTH BENNINGTON
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State | VT
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Zip | 05257-9167
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Country | US
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Telephone | 802-736-6218
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Fax | 802-277-7309
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | MARY LAURA NAYLOR HULTGREN
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Credential | MOTR/L
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Telephone | 802-736-6218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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