Provider Demographics
NPI:1093943755
Name:CODDOU, PABLO (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:PABLO
Middle Name:
Last Name:CODDOU
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1177 N CRAFTSBURY RD
Mailing Address - Street 2:
Mailing Address - City:CRAFTSBURY COMMON
Mailing Address - State:VT
Mailing Address - Zip Code:05827-6801
Mailing Address - Country:US
Mailing Address - Phone:802-533-7721
Mailing Address - Fax:
Practice Address - Street 1:1177 N CRAFTSBURY RD
Practice Address - Street 2:
Practice Address - City:CRAFTSBURY COMMON
Practice Address - State:VT
Practice Address - Zip Code:05827-6801
Practice Address - Country:US
Practice Address - Phone:303-413-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health