Individual
DR. JACEY RAENELLE COURSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD.
Contact information
Practice address
1315 HOSPITAL DR, ST JOHNSBURY, VT 05819-9210
(802) 748-2984
(802) 748-1778
Mailing address
PO BOX 905, ST JOHNSBURY, VT 05819-0905
(802) 748-8141
(802) 748-4098
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
8051143
VT
231H00000X
Audiologist
A615
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021087
—
VT
05
—
3084249
—
NH
Enumeration date
09/25/2012
Last updated
04/19/2017
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