Provider Demographics
NPI:1649932096
Name:VECCHIONE, LEONARD
Entity type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:VECCHIONE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 243
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05676-0243
Mailing Address - Country:US
Mailing Address - Phone:802-272-3750
Mailing Address - Fax:
Practice Address - Street 1:982 BEAR HILL RD
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:VT
Practice Address - Zip Code:05060-9030
Practice Address - Country:US
Practice Address - Phone:802-272-3750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities