Provider Demographics
NPI:1538478839
Name:ARBOGAST, GLORIA (LCMHC)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:
Last Name:ARBOGAST
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 UPPER PLN
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05033-9207
Mailing Address - Country:US
Mailing Address - Phone:802-222-4722
Mailing Address - Fax:802-222-4709
Practice Address - Street 1:331 UPPER PLN
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:VT
Practice Address - Zip Code:05033-9207
Practice Address - Country:US
Practice Address - Phone:802-222-4722
Practice Address - Fax:802-222-4709
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0068.0055652101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health