Individual
MR. OLIVER A QUAYLE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LIC PSY. MA & LCMHC
Contact information
Practice address
107 FISHER POND RD, ST ALBANS, VT 05478-6286
(802) 524-6555
(802) 524-6562
Mailing address
322 TERRACE DR, WILLISTON, VT 05495-2130
(802) 878-6355
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
047-0000664
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007192
—
VT
01
—
29870
BCBS
VT
01
—
357569
MHN
VT
01
—
CIGNA
2052639
VT
Enumeration date
02/21/2006
Last updated
07/08/2007
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