MEDICARE: VIRGINIA F FLEET M.ED.

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	4899	MA

General Provider Information

NPI Number	:	1851302913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA F FLEET M.ED.

Provider Business Mailing Address
First Line	:	880 GREEN RIVER RD
Second Line	:
City	:	GUILFORD
State	:	VT
Zip	:	05301-8114
Country	:	US
Telephone Number	:	413-774-6252
Fax Number	:

Provider Business Practice Location Address
First Line	:	238 MAIN ST
Second Line	:
City	:	GREENFIELD
State	:	MA
Zip	:	01301-3243
Country	:	US
Telephone Number	:	413-774-6252
Fax Number	:

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	07/08/2007

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