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Individual

ANGELIQUE PARKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LCMHC

Contact information

Practice address
168 NORTH ST, BENNINGTON, VT 05201-1874
(802) 342-4636
Mailing address
106 CROSS ST, BENNINGTON, VT 05201-2046
(802) 881-9519

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068.0134668
VT
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
07/31/2019
Last updated
07/27/2022
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