Individual
MS. JOAN KUNDIN DOUBLEDAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
20 W PARK ST, LEBANON, NH 03766-1378
(603) 448-9925
(802) 295-2441
Mailing address
20 W PARK ST, LEBANON, NH 03766-1378
(603) 448-9925
(802) 295-2441
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
181
VT
101YM0800X
Mental Health Counselor
Primary
239
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010107
—
VT
01
—
181
LICENSE #
VT
01
—
239
LICENSE #
NH
05
—
30007245
—
NH
01
—
DOUB09984
BC/BS OF VT ID#
VT
Enumeration date
10/13/2006
Last updated
07/08/2007
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