| Doctor Name: | MS. BRIDGET LEICESTER |
| NPI Number: | 1063448694 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LICSW |
| License Number: | R042998-1 |
| Business Practice Address: | 90 Mahoney Ave Psychiatry & Psychotherapy Assocs Rutland, VT - 057010000 |
| Business Phone Number: | 8027752581 |
| Business Fax Number: | 8027753395 |
| Mailing Address: | Po Box 305, PROCTORSVILLE |
| State: | VT |
| Postal Code: | 051530000 |
| Phone Number: | 8022267450 |
| Fax Number: | |
| NPI Enumeration Date: | 06/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | R042998-1 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |