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General NPI Number Information
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NPI Number | 1871110940
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Entity Type | Organization
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Legal Business Name | HOPE AND RESILIENCE THERAPY, LLC
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Dates
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Enumeration Date | 07/06/2020
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 12 RIVER ST UNIT 103
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City | MILTON
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State | VT
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Zip | 05468-3628
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Country | US
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Telephone | 802-752-5976
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 461
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City | MILTON
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State | VT
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Zip | 05468-0461
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Country | US
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Telephone | 802-752-5976
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Fax |
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Authorized Official
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Title or Position | LICSW
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Name | SHAINA LUSSIER
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Credential | LICSW
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Telephone | 802-752-5976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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