Provider Information for 1811362619
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NANCY KENYON RICHARDSON LCMHC
Sex: Female
NPI: 1811362619
Last Updated: 2024-05-24
Certification Date: 2024-05-24
Certification Date: 2024-05-24
Details
| Name | Value | ||||||||||||
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| NPI | 1811362619 | ||||||||||||
| Enumeration Date | 2015-12-04 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 1468 MONTPELIER, VT 05601-1468 United States Phone: 802-223-4156 | Fax:802-223-4332 | ||||||||||||
| Primary Practice Address | 100 HOSPITALITY DRIVE BERLIN, VT 05641 United States Phone: 802-223-4156 | Fax:802-223-4332 | ||||||||||||
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