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General NPI Number Information
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NPI Number | 1528281417
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Entity Type | Individual
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Provider Name | BERNADETTE GUIDRY M.S.
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Gender | Female
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 82 CATAMOUNT PARK
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City | MIDDLEBURY
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State | VT
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Zip | 05753-1292
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Country | US
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Telephone | 802-388-7185
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Fax |
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Provider Business Mailing Address
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Address Line | 672 W 11TH ST SUITE 337
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City | TRACY
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State | CA
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Zip | 95376-3821
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Country | US
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Telephone | 209-627-8345
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 50705
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 100-0133998
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License Number State | VT
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