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General NPI Number Information
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NPI Number | 1093492605
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Entity Type | Organization
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Legal Business Name | GABRIEL VEGA COUNSELING, PLLC
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Dates
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Enumeration Date | 07/05/2023
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 11 SOUTHMAYD ST UNIT 2184
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City | CAMPTON
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State | NH
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Zip | 03223-8008
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Country | US
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Telephone | 603-412-2755
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2184
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City | CAMPTON
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State | NH
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Zip | 03223-2184
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Country | US
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Telephone | 603-412-2755
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GABRIEL JOSE VEGA
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Credential | M.S., LCMHC
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Telephone | 603-412-2755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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