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NPI Code Detail

MEDICARE: MS. MARY-ELLEN GIROUX M.A.

MEDICARE: MS. MARY-ELLEN GIROUX M.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist614VT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528273851
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARY-ELLEN GIROUX M.A.
Provider Business Mailing Address
First Line : 67 LINCOLN ST
Second Line :
City : ESSEX JUNCTION
State : VT
Zip : 05452-3235
Country : US
Telephone Number : 802-878-7126
Fax Number : 802-878-9966
Provider Business Practice Location Address
First Line : 67 LINCOLN ST
Second Line :
City : ESSEX JUNCTION
State : VT
Zip : 05452-3235
Country : US
Telephone Number : 802-878-7126
Fax Number : 802-878-9966
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2007
Last Update Date : 07/08/2007

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