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Mr. Blake Vicent Ireland
Student in an Organized Health Care Education/Training Program in Northfield, Vermont
NPI 1154844504

Blake Vicent Ireland is a Student in an Organized Health Care Education/Training Program based in Waterbury, VT. Blake Vicent Ireland practices in Northfield, VT. The NPI Number for Blake Vicent Ireland is 1154844504 and holds a License No. (Vermont).

The current practice location address for Blake Vicent Ireland is 158 Harmon Dr, Northfield, VT and can be reached out via phone at 203-565-1815.

Location: 158 Harmon Dr, Northfield, VT, 06706-1604
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1154844504
Provider Name
Blake Vicent Ireland
Credential
Provider Entity Type
Individual
Gender
Male
Address
158 Harmon Dr, Northfield, VT, 06706-1604
Phone Number
203-565-1815
Fax Number
Provider Enumeration Date
07/18/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
158 Harmon Dr
City
Northfield
State
Vermont
Zip
05663-1000
Phone Number
203-565-1815
Fax Number
person
Provider Business Mailing Address Details
Address
158 Harmon Dr
City
Northfield
State
Vermont
Zip
05663-1000
Phone Number
203-565-1815
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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