Provider Demographics
NPI:1396752994
Name:AULETTA, JENNIFER ANN (MA, LCMHC, DTR)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ANN
Last Name:AULETTA
Suffix:
Gender:F
Credentials:MA, LCMHC, DTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 BARRE ST
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-3671
Mailing Address - Country:US
Mailing Address - Phone:802-279-5809
Mailing Address - Fax:
Practice Address - Street 1:CVMC, OB/GYN/MIDWIFERY, BLDG A, SUITE 1-4
Practice Address - Street 2:130 FISHER ROAD
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-4124
Practice Address - Country:US
Practice Address - Phone:802-371-5961
Practice Address - Fax:802-371-5960
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0000665101YM0800X
VT068-0000665101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT2080OtherBLUEPRINT FOR HEALTH