Provider Demographics
NPI:1841754553
Name:VECCHIONE POLTL, JOIE LYNETTE (AMFT)
Entity type:Individual
Prefix:
First Name:JOIE
Middle Name:LYNETTE
Last Name:VECCHIONE POLTL
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 SAINT ANDREWS CIR
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-4636
Mailing Address - Country:US
Mailing Address - Phone:805-550-5447
Mailing Address - Fax:
Practice Address - Street 1:1244 PINE ST STE 218
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-7242
Practice Address - Country:US
Practice Address - Phone:805-550-5447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-27
Last Update Date:2019-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76040101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor