Provider Demographics
NPI:1497879746
Name:DROR, MIRIAM LEAH (MA, LCMHC)
Entity Type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:LEAH
Last Name:DROR
Suffix:
Gender:F
Credentials:MA, LCMHC
Other - Prefix:MISS
Other - First Name:MIRIAM
Other - Middle Name:LEAH
Other - Last Name:WIKLENFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 EAST WEST RD
Mailing Address - Street 2:
Mailing Address - City:EAST DUMMERSTON
Mailing Address - State:VT
Mailing Address - Zip Code:05346
Mailing Address - Country:US
Mailing Address - Phone:802-258-1709
Mailing Address - Fax:
Practice Address - Street 1:24 EAST WEST RD
Practice Address - Street 2:
Practice Address - City:EAST DUMMERSTON
Practice Address - State:VT
Practice Address - Zip Code:05340
Practice Address - Country:US
Practice Address - Phone:802-257-7916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0680000115101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1013093Medicaid