Provider Demographics
NPI:1073871034
Name:VITALIS, BARBARA ELIZABETH (MA)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:ELIZABETH
Last Name:VITALIS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 MORNINGSIDE CMNS
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-3631
Mailing Address - Country:US
Mailing Address - Phone:802-380-1243
Mailing Address - Fax:
Practice Address - Street 1:39 MORNINGSIDE CMNS
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-3631
Practice Address - Country:US
Practice Address - Phone:802-380-1243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-27
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)