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General NPI Number Information
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NPI Number | 1972809101
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Entity Type | Individual
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Provider Name | ANN E LAROCQUE LCMHC
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Gender | Female
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Dates
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Enumeration Date | 02/05/2011
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Last Update Date | 02/05/2011
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Provider Practice Location Address
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Address Line | 32 PLEASANT ST
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City | WOODSTOCK
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State | VT
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Zip | 05091-1122
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Country | US
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Telephone | 802-672-1891
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 224
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City | BRIDGEWATER
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State | VT
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Zip | 05034-0224
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Country | US
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Telephone | 802-672-1891
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0680000731
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License Number State | VT
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