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Individual

MS. MARA E. CICALONI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., LCMHC

Contact information

Practice address
287 MAIN ST., CHESTER, VT 05143
(802) 875-5335
(802) 875-5337
Mailing address
PO BOX 844, CHESTER, VT 05143-0844
(802) 875-5335
(802) 875-5337

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068-0000643
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00068213
BCBS
VT
05
1010770
VT
01
2031051
CIGNA BH
VT
01
58671100
MAGELLAN
VT
01
787462
MVP
VT
Enumeration date
09/20/2006
Last updated
07/08/2007
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