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General NPI Number Information
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NPI Number | 1902569924
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Entity Type | Individual
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Provider Name | KRISTINE PEELER LCMHC
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Gender | Female
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Dates
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Enumeration Date | 10/17/2021
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Last Update Date | 10/17/2021
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Provider Practice Location Address
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Address Line | 250 MAIN ST
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City | MONTPELIER
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State | VT
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Zip | 05602-4257
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Country | US
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Telephone | 802-798-2714
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Fax |
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Provider Business Mailing Address
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Address Line | 644 LOG TOWN RD
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City | EAST CALAIS
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State | VT
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Zip | 05650-8276
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Country | US
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Telephone | 802-798-2714
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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 | 068.0134399
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License Number State | VT
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