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General NPI Number Information
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NPI Number | 1720447725
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Entity Type | Individual
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Provider Name | HANNAH GOGUEN M.S.
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Gender | Female
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Dates
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Enumeration Date | 02/18/2016
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Last Update Date | 06/02/2023
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Provider Practice Location Address
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Address Line | 73 MAIN ST SUITE 19
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City | MONTPELIER
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State | VT
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Zip | 05602-2932
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Country | US
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Telephone | 802-535-8191
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Fax |
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Provider Business Mailing Address
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Address Line | 1938 VT ROUTE 15
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City | WEST DANVILLE
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State | VT
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Zip | 05873-9805
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Country | US
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Telephone | 802-535-8191
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 068.0134226
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License Number State | VT
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