Healthcare Provider Details

I. General information

NPI: 1477588994
Provider Name (Legal Business Name): ANNE LOUISE UNANGST M.A., M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 DRAGONFLY LN # 189
CALAIS VT
05648-7619
US

IV. Provider business mailing address

84 DRAGONFLY LN # 189
CALAIS VT
05648-7619
US

V. Phone/Fax

Practice location:
  • Phone: 802-223-1225
  • Fax:
Mailing address:
  • Phone: 802-223-1225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number239
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: