Individual
MRS. HOLLY S WAKEFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC LPC
Contact information
Practice address
67 FAIRFIELD ST, ST ALBANS, VT 05478
(802) 524-8747
Mailing address
67 FAIRFIELD ST, ST ALBANS, VT 05478
(802) 524-8747
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0000511
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007521
—
VT
Enumeration date
11/21/2006
Last updated
01/10/2024
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