Provider Demographics
NPI:1235201948
Name:JEFFERY, JOANNA E (MSW)
Entity Type:Individual
Prefix:MS
First Name:JOANNA
Middle Name:E
Last Name:JEFFERY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-4346
Mailing Address - Country:US
Mailing Address - Phone:802-598-4865
Mailing Address - Fax:
Practice Address - Street 1:34 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4346
Practice Address - Country:US
Practice Address - Phone:802-598-4865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical