Willis, Jessica
Willis, Jessica is an sole proprietor health care provider with primary practice located at 35 King St Suite 8, Burlington VT 05401-4880. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Willis, Jessica can be contacted via phone (802) 363-4311.Contact Information
Primary practice address
35 King St Suite 8
Burlington VT 05401-4880
Phone: (802) 363-4311
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 047.0102268 | Vermont |
Profile Details
| NPI number | 1861894727 |
|---|---|
| LBN Legal business name | Willis, Jessica |
| Credentials | Master of Arts (MA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 23rd, 2014 |
| Last updated | Jan 10th, 2015 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861894727 | NPPES |
| Vermont | MEDICAID | 1023934 |
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