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Individual
JERRI BROUILLETTE
Active
Individual
JERRI BROUILLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
151.0125298
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
151.0125298
STATE LICENSE
VT
Enumeration date
12/06/2017
Last updated
12/06/2017
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