Organization
JENNIFER FAUNTLEROY, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER MARY FAUNTLEROY M.D. (OWNER)
(802) 775-1398
Entity
Organization
Contact information
Practice address
11 COURT SQ, RUTLAND, VT 05701-4030
(802) 775-1398
(802) 775-5196
Mailing address
11 COURT SQ, RUTLAND, VT 05701-4030
(802) 775-1398
(802) 775-5196
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
042-0009568
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN1669
—
VT
Enumeration date
07/14/2006
Last updated
08/22/2020
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