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PAUL GIBEAULT M.A.

>> Psychologist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1215099981

Individual Registrant:
 PAUL  GIBEAULT M.A.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
30 AIRPORT RD  S BURLINGTON, VT 05403-6432 US
Tel: 802-658-3924  Fax: 802-658-0216

Contact information for business:
30 AIRPORT RD  S BURLINGTON, VT 05403-6432 US
Tel: 802-658-3924  Fax: 802-658-0216

Registration Information:
NPI: 1215099981
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103T00000XBehavioral Health & Social Service Providers
Psychologist
VT047-0000718

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
1011871VT05
BC BS PROVIDER NUMBER00069123VT01




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