Search › Vermont › 1041C0700X
Bonita Fazio, LICSW
NPI 1699826602 · on the registry since 2007 · sole proprietor
Practice
- Address
- 297 Summer St
Kingdom Recovery Center
St Johnsbury, VT 05819 - Phone
- (802) 748-2524
- Fax
- (802) 748-2524
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Also registered as
- 1041C0700X
- Licence states on file
- VT, MA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2008-06-06
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Vermont