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Individual

ROBERT VAILLANCOURT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.A.

Contact information

Practice address
768 S MAIN ST, BETHEL, VT 05032-4472
(802) 234-5691
(802) 763-7048
Mailing address
PO BOX 263, BETHEL, VT 05032-0263
(802) 234-5691
(802) 763-7048

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0470000611
VT

Other

Enumeration date
06/28/2006
Last updated
12/12/2018
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