MEDICARE: BRYANNA VAIL LMHC

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
1	101YM0800X	Mental Health Counselor	10842	MA

General Provider Information

NPI Number	:	1831460559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRYANNA VAIL LMHC

Provider Business Mailing Address
First Line	:	PO BOX 23
Second Line	:
City	:	ROCHDALE
State	:	MA
Zip	:	01542
Country	:	US
Telephone Number	:	508-471-5261
Fax Number	:

Provider Business Practice Location Address
First Line	:	714B SOUTHBRIDGE ST
Second Line	:
City	:	AUBURN
State	:	MA
Zip	:	01501-1821
Country	:	US
Telephone Number	:	508-471-5261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2012
Last Update Date	:	07/23/2019

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Directions to “ BRYANNA VAIL LMHC” Practice Location

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