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General NPI Number Information
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NPI Number | 1932068822
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Entity Type | Individual
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Provider Name | JENNIFER JENNIFER KATSUVA
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Gender | Female
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Dates
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Enumeration Date | 01/17/2026
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Last Update Date | 01/17/2026
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Provider Practice Location Address
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Address Line | 600 BLAIR PARK RD STE 306
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City | WILLISTON
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State | VT
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Zip | 05495-7855
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Country | US
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Telephone | 802-655-7110
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Fax |
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Provider Business Mailing Address
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Address Line | 600 BLAIR PARK RD STE 306
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City | WILLISTON
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State | VT
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Zip | 05495-7855
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 101.0138409
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License Number State | VT
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