| 15 East Collective Llc | |
|
1225 Vt-15 Wolcott VT 05680 | |
| (802) 323-8392 | |
| Not Available |
| Full Name | 15 East Collective Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1225 Vt-15, Wolcott, Vermont |
| Authorized Official Name and Position | Darrin Greene (PSYCHOLOGIST MASTERS LEVEL) |
| Authorized Official Contact | 8023231236 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 15 East Collective Llc 1225 Vt 15 Wolcott VT 05680-3034 Ph: (802) 323-8392 | 15 East Collective Llc 1225 Vt-15 Wolcott VT 05680 Ph: (802) 323-8392 |
| NPI Number | 1285479162 |
|---|---|
| Provider Enumeration Date | 07/01/2024 |
| Last Update Date | 11/01/2024 |
| Certification Date | 10/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285479162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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