Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175F00000X | Naturopath | 099-0000186 | VT |
Y | 175F00000X | Naturopath | NP-0008 | DC |
NPI | 1134266588 |
---|---|
Provider Name | Dr. Charlene Kannankeril |
First Address | Washington, DC 20015-2014 |
Second Address | Washington, DC 20015-2014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 13/09/2008 |