Provider Demographics
NPI:1699140228
Name:NORONA, WILMA (LADC)
Entity type:Individual
Prefix:
First Name:WILMA
Middle Name:
Last Name:NORONA
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:W
Other - Middle Name:C
Other - Last Name:NORONA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LADC
Mailing Address - Street 1:1 KENNEDY DR # 4
Mailing Address - Street 2:
Mailing Address - City:SOUTH BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403-7152
Mailing Address - Country:US
Mailing Address - Phone:802-338-2267
Mailing Address - Fax:
Practice Address - Street 1:1 KENNEDY DR # 4
Practice Address - Street 2:
Practice Address - City:SOUTH BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403-7152
Practice Address - Country:US
Practice Address - Phone:023-382-2678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-08
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT000439101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)