Individual
NORMA JOANNE VAILLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC, MT-BC
Contact information
Practice address
215 E OAK ST, LAKELAND, FL 33801-4841
(863) 284-0817
(863) 284-0608
Mailing address
215 E OAK ST, LAKELAND, FL 33801-4841
(863) 284-0817
(863) 284-0608
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
MH7955
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000921800
—
FL
01
—
7561664
AETNA
FL
01
—
790160-000
MAGELLAN
FL
01
—
Z084D
BLUECROSS BLUESHIELD
FL
Enumeration date
08/29/2006
Last updated
09/04/2020
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