Individual
KELLEY TESSIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
28 CORNELIA CT UNIT 104, MILTON, VT 05468-4657
(802) 274-8116
(844) 742-8384
Mailing address
28 CORNELIA CT UNIT 104, MILTON, VT 05468-4657
(802) 274-8116
(844) 742-8384
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
151.0125376
VT
101YM0800X
Mental Health Counselor
Primary
068.0100151
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025703
—
VT
05
—
1026417
—
VT
Enumeration date
06/03/2014
Last updated
12/11/2023
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