Provider Demographics
NPI:1992958300
Name:VEINOTTE, VALERIE (LMT)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:VEINOTTE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 BIRCH LEDGE RD
Mailing Address - Street 2:
Mailing Address - City:HOLLIS CENTER
Mailing Address - State:ME
Mailing Address - Zip Code:04042-3344
Mailing Address - Country:US
Mailing Address - Phone:207-773-7788
Mailing Address - Fax:
Practice Address - Street 1:1 CITY CTR
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-6420
Practice Address - Country:US
Practice Address - Phone:207-773-7788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMT3605174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME202151OtherANTHEM BLUE CROSS BLUE SHIELD