Provider Demographics
NPI:1477588994
Name:UNANGST, ANNE LOUISE (MA, MED)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:LOUISE
Last Name:UNANGST
Suffix:
Gender:F
Credentials:MA, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1943 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-8637
Mailing Address - Country:US
Mailing Address - Phone:802-223-1225
Mailing Address - Fax:802-223-6145
Practice Address - Street 1:162 ELM ST
Practice Address - Street 2:SUITE 3
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-2896
Practice Address - Country:US
Practice Address - Phone:802-223-1225
Practice Address - Fax:802-223-6145
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT239103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0002615Medicaid
VT239OtherVT PSYCHOLOGY LICENSE #