Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 089-0000985 | VT |
NPI | 1003040874 |
---|---|
Provider Name | Virginia Alden Gold |
First Address | Springfield, VT 05156-2226 |
Second Address | Springfield, VT 05156-2226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2009 |
Last Update Date | 08/05/2009 |