Provider Demographics
NPI:1851302913
Name:FLEET, VIRGINIA F (MED)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:F
Last Name:FLEET
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 GREEN RIVER RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05301-8114
Mailing Address - Country:US
Mailing Address - Phone:413-774-6252
Mailing Address - Fax:
Practice Address - Street 1:238 MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-3243
Practice Address - Country:US
Practice Address - Phone:413-774-6252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4899101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health