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Individual

DEBBIE S DEFORGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCMHC

Contact information

Practice address
9 HEATON ST, MONTPELIER, VT 05602-2489
(802) 223-6328
(802) 229-8004
Mailing address
PO BOX 647, MONTPELIER, VT 05601-0647
(802) 223-6328
(802) 229-8004

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0000518
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00059451
BC/BS OF VT
VT
05
1009626
VT
01
2153574
CIGNA
VT
01
360276
TRICARE
VT
01
989026C
MVP HEALTHCARE
VT
Enumeration date
09/16/2006
Last updated
04/06/2010
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