Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 099.0085570 | VT |
N | 175F00000X | Naturopath | 0990085570 | VT |
N | 208D00000X | General Practice Physician | 099.0085570 | VT |
NPI | 1053667477 |
---|---|
Provider Name | Dr. Jennifer Williamson |
First Address | Burlington, VT 05401 |
Second Address | Burlington, VT 05401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2012 |
Last Update Date | 25/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1020995 | (05) | VT |