Individual
MARY G. COVENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LCMHC
Contact information
Practice address
51 FAIRVIEW STREET, BRATTLEBORO, VT 05301-6629
(802) 254-6028
(802) 254-7501
Mailing address
390 RIVER STREET, SPRINGFIELD, VT 05156-2226
(802) 886-4500
(802) 886-4560
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0134112
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1034763
—
VT
Enumeration date
06/16/2015
Last updated
09/20/2019
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