Tetrault, Diane M
Tetrault, Diane M is an individual health care provider with primary practice located at 138 Main St , Montpelier VT 05602. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Tetrault, Diane M can be contacted via phone (802) 229-1643.Contact Information
Primary practice address
138 Main St
Montpelier VT 05602
Phone: (802) 229-1643
Fax: (802) 229-1643
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 0680000627 | Vermont |
Profile Details
NPI number | 1861533119 |
---|---|
LBN Legal business name | Tetrault, Diane M |
Credentials | MA LCMHC |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 9th, 2007 |
Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1861533119 | NPPES |
Vermont | Other | 00068835 | BCBS MAGELEN |
Vermont | Other | 389311 | BCBS MAGELEN |
Vermont | Other | 581232 | BCBS MAGELEN |
Vermont | Other | 2316710 | BCBS MAGELEN |
Vermont | MEDICAID | 1011810 | BCBS MAGELEN |
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