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General NPI Number Information
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NPI Number | 1942304449
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Entity Type | Individual
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Provider Name | ROBERT FRANKLIN WOLFORD LICSW
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Gender | Male
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 05/20/2011
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Provider Practice Location Address
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Address Line | 855 PINE ST
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City | BURLINGTON
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State | VT
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Zip | 05401-4924
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Country | US
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Telephone | 802-488-6103
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Fax | 802-488-6919
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Provider Business Mailing Address
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Address Line | 208 FLYNN AVE 3J
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City | BURLINGTON
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State | VT
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Zip | 05401-5429
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Country | US
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Telephone | 802-488-6900
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Fax | 802-488-6919
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 089-0000282
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License Number State | VT
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