Basic Information
| Provider Information | |||||||||
| NPI: | 1114472776 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KRAUS | ||||||||
| FirstName: | ALLYSON | ||||||||
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| Credential: | M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 86 LAKE ST | ||||||||
| Address2: | |||||||||
| City: | BURLINGTON | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054015297 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 112 LAKE ST | ||||||||
| Address2: | |||||||||
| City: | BURLINGTON | ||||||||
| State: | VT | ||||||||
| PostalCode: | 05401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8028653450 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2016 | ||||||||
| LastUpdateDate: | 11/16/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | IMF96786 | CA | N | Behavioral Health & Social Service Providers | Marriage & Family Therapist | 106H00000X | 097.0134166 | VT | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.