| Liza Mitrofanova Pllc | |
|
314 Upper Houghton Rd. Unit B Marlboro VT 05344 | |
| (802) 380-9867 | |
| Not Available |
| Full Name | Liza Mitrofanova Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 314 Upper Houghton Rd., Marlboro, Vermont |
| Authorized Official Name and Position | Elizaveta Mitrofanova (MEMBER) |
| Authorized Official Contact | 8023809867 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liza Mitrofanova Pllc Po Box 322 Marlboro VT 05344-0322 Ph: (802) 380-9867 | Liza Mitrofanova Pllc 314 Upper Houghton Rd. Unit B Marlboro VT 05344 Ph: (802) 380-9867 |
| NPI Number | 1851219075 |
|---|---|
| Provider Enumeration Date | 07/07/2026 |
| Last Update Date | 07/07/2026 |
| Certification Date | 06/14/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851219075 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |