Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 000368 | CT |
NPI | 1154629731 |
---|---|
Provider Name | Dr. Dori Vallis |
First Address | Ridgefield, CT 06877-3605 |
Second Address | Darien, CT 06820-3631 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2011 |
Last Update Date | 07/03/2011 |