Provider Demographics
NPI:1750543062
Name:DELORME, MONICA JEANNE (LAC)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:JEANNE
Last Name:DELORME
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 US ROUTE 4E
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MENDON
Mailing Address - State:VT
Mailing Address - Zip Code:05777
Mailing Address - Country:US
Mailing Address - Phone:802-786-0690
Mailing Address - Fax:
Practice Address - Street 1:13 US ROUTE 4
Practice Address - Street 2:SUITE 2
Practice Address - City:MENDON
Practice Address - State:VT
Practice Address - Zip Code:05701-9320
Practice Address - Country:US
Practice Address - Phone:802-786-0690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT091 0000079171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist