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Individual

MS. AMENA MACSHEA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCMHC

Contact information

Practice address
77 DENSMORE HILL, HARTLAND FOUR CORNERS, VT 05049
(802) 436-2133
Mailing address
PO BOX 74, HARTLAND FOUR CORNERS, VT 05049-0074
(802) 436-2133
(802) 436-1733

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0000711
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11514819
CAQH PROVIDER ID
VT
Enumeration date
07/02/2007
Last updated
07/08/2007
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