Individual
CAROL A LOEFFLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
82 ELM ST, MANCHESTER CENTER, VT 05255-9642
(802) 867-7035
(802) 367-1069
Mailing address
82 ELM ST, MANCHESTER CENTER, VT 05255-9642
(802) 867-7035
(802) 367-1069
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5201
OH
103TC0700X
Clinical Psychologist
5201
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000325622
ANTHEM BC
OH
01
—
03818
PARAMOUNT HEALTHCARE
OH
05
—
1024899
—
VT
05
—
2015796
—
OH
01
—
271070000
MAGELLAN
OH
01
—
281743
TRICARE CHAMPUS
OH
01
—
5949417
AETNA
OH
01
—
P620004623
RR MEDICARE
OH
Enumeration date
06/27/2005
Last updated
12/08/2015
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