Doctor Name: | MR. DAVID GAUTHIER |
NPI Number: | 1104997279 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA |
License Number: | 0680000037 |
Business Practice Address: | 432 Main St Winooski, VT - 054041338 |
Business Phone Number: | 8026553311 |
Business Fax Number: | |
Mailing Address: | 432 Main St, WINOOSKI |
State: | VT |
Postal Code: | 054041338 |
Phone Number: | 8026553311 |
Fax Number: | |
NPI Enumeration Date: | 11/12/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 0680000037 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |