Individual
RITA FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
178 KELADY DR, SHELBURNE, VT 05482-6450
(802) 985-4961
Mailing address
178 KELADY DR, SHELBURNE, VT 05482-6450
(802) 985-4961
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0680000567
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59987
BCBS PROVIDER NUMBER
VT
Enumeration date
05/04/2007
Last updated
07/08/2007
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