Individual
DR. JAY MIREAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
852 MAGGIES WAY, WATERBURY CENTER, VT 05677-8034
(802) 244-6146
Mailing address
852 MAGGIES WAY, WATERBURY CENTER, VT 05677-8034
(802) 244-6146
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
048-0000296
VT
Other
Enumeration date
07/08/2006
Last updated
07/08/2007
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