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:
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Health care specialties

SpecialtyCodeLicense #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 17 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.

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Identifiers

StateTypeNumberIssuer
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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