Individual
DANIELLE LERICHE-FORKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1815 VT RTE 15, WOLCOTT, VT 05680-3008
(802) 696-9830
Mailing address
PO BOX 1002, WOLCOTT, VT 05680
(802) 696-9830
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
047.0133681
VT
Other
Enumeration date
04/28/2020
Last updated
06/23/2020
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