Individual
MS. TINA L DESMARAIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
879 GRAY RD, PLAINFIELD, VT 05667-9050
(802) 223-1177
(802) 223-1177
Mailing address
879 GRAY RD, PLAINFIELD, VT 05667-9050
(802) 223-1177
(802) 223-1177
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0000446
VT
101YM0800X
Mental Health Counselor
068.0000446
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1006769
—
VT
Enumeration date
06/04/2006
Last updated
02/24/2024
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