| Jacquelyn E. Bode, M.ed., Inc. | |
|
73 Center St Rutland VT 05701-4046 | |
| (802) 747-3488 | |
| (802) 747-0006 |
| Full Name | Jacquelyn E. Bode, M.ed., Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 73 Center St, Rutland, Vermont |
| Authorized Official Name and Position | Jacquelyn Ellen Bode (PRESIDENT) |
| Authorized Official Contact | 8027473488 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacquelyn E. Bode, M.ed., Inc. 73 Center St Rutland VT 05701-4046 Ph: (802) 747-3488 | Jacquelyn E. Bode, M.ed., Inc. 73 Center St Rutland VT 05701-4046 Ph: (802) 747-3488 |
| NPI Number | 1730497504 |
|---|---|
| Provider Enumeration Date | 09/15/2010 |
| Last Update Date | 09/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730497504 | NPI | - | NPPES |
| 0002611 | Medicaid | VT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 047.0000269 (Vermont) | Primary |
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