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Individual

JENNIFER DUBUQUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCMHC

Contact information

Practice address
ISLAND POND HEALTH CENTER, 82 MAPLE ST, ISLAND POND, VT 05846
(802) 723-4300
(802) 723-4544
Mailing address
165 SHERMAN DR, ST JOHNSBURY, VT 05819-9811
(802) 748-9405

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
068.0134279
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
068.0134279
STATE OF VERMONT
VT
Enumeration date
02/11/2021
Last updated
02/11/2021
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