Provider Demographics
NPI:1346644010
Name:VEINOT, JAN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JAN
Middle Name:
Last Name:VEINOT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 BAYVIEW ST
Mailing Address - Street 2:
Mailing Address - City:YARMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04096-6900
Mailing Address - Country:US
Mailing Address - Phone:207-712-2597
Mailing Address - Fax:
Practice Address - Street 1:41 BAYVIEW ST
Practice Address - Street 2:
Practice Address - City:YARMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04096-6900
Practice Address - Country:US
Practice Address - Phone:207-712-2597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL4393101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health