| Idlewild Associates, Llc | |
|
153 Main St Poultney VT 05764-4413 | |
| (802) 287-0841 | |
| Not Available |
| Full Name | Idlewild Associates, Llc |
|---|---|
| Speciality | Counselor |
| Location | 153 Main St, Poultney, Vermont |
| Authorized Official Name and Position | Lisa Ann Citarella (CO-OWNER) |
| Authorized Official Contact | 8022870841 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idlewild Associates, Llc Po Box 7 Poultney VT 05764-0007 Ph: (802) 287-0841 | Idlewild Associates, Llc 153 Main St Poultney VT 05764-4413 Ph: (802) 287-0841 |
| NPI Number | 1164800884 |
|---|---|
| Provider Enumeration Date | 05/14/2015 |
| Last Update Date | 05/14/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164800884 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 097.0107404 (Vermont) | Primary |
Emdr Counseling And Consultation, Plc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1528 Vt Route 30 S, Poultney, VT 05764 Phone: 802-432-2595 |