ELVIS LACOSTE

RUTLAND, VT
NPI1568987907
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: VT  1510127405)
Enumeration Date2017-08-07
Last Update Date2017-08-07
Business Address
ELVIS LACOSTE LADC
135 GRANGER ST
RUTLAND, VT 05701-4405
Phone number: 802-747-3588
Mailing Address
ELVIS LACOSTE LADC
78 S MAIN ST
RUTLAND, VT 05701-4591
Phone number: 802-775-8224
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