Provider Demographics
NPI:1417309006
Name:TOOKER, KATHRYN (MSW, MPH, LICSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:TOOKER
Suffix:
Gender:F
Credentials:MSW, MPH, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 BILLINGS FARM RD STE 2E-4
Mailing Address - Street 2:
Mailing Address - City:WHITE RIVER JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05001-5401
Mailing Address - Country:US
Mailing Address - Phone:802-222-6954
Mailing Address - Fax:
Practice Address - Street 1:205 BILLINGS FARM RD STE 2E-4
Practice Address - Street 2:
Practice Address - City:WHITE RIVER JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05001-5401
Practice Address - Country:US
Practice Address - Phone:802-222-6954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH25201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical