Individual
MS. MARTHA JEAN COULTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
128 MERCHANTS ROW, 6TH FLOOR, RUTLAND, VT 05701-5909
(802) 773-1411
(802) 775-7319
Mailing address
257 S. MAIN ST., RCSU, RUTLAND, VT 05701
(802) 773-1411
(802) 775-7319
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
000194-1
NY
103T00000X
Psychologist
Primary
0470000386
VT
103TS0200X
School Psychologist
—
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
062-2690
BLUE CROSS AND BLUE SHLD
VT
05
—
1002138
—
VT
01
—
120304000
MAGELLAN HEALTH SERVICES
VT
01
—
2028356
CIGNA
VT
01
—
956673
MVP
VT
01
—
VF6352
EMPIRE BC/BS
NY
Enumeration date
03/02/2007
Last updated
11/14/2009
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