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Individual

YANNICK G CHASSEREAU

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA

Contact information

Practice address
23 JONES BROTHERS WAY, BARRE, VT 05641-2527
(802) 479-4083
(802) 476-1476
Mailing address
PO BOX 647, MONTPELIER, VT 05601-0647
(802) 479-4083
(802) 476-1476

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
047-0045067
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1016249
VT
01
1033351648
BLUE CROSS/BLUE SHIELD OF VERMONT
VT
01
2167005
CIGNA
VT
01
443012
MHN TRICARE
VT
01
989026C
MVP HEALTHCARE
VT
Enumeration date
03/27/2009
Last updated
02/04/2010
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