Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 099-0000230 | VT |
NPI | 1063540623 |
---|---|
Provider Name | Dr. Emily M Cannon |
First Address | East Middlebury, VT 05740-0705 |
Second Address | Middlebury, VT 05753-8806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/03/2007 |
Last Update Date | 08/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1015227 | (05) | VT |