Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | NP301 | ME |
NPI | 1003280611 |
---|---|
Provider Name | Dr. Joelle Haynes Laclair |
First Address | Bremen, ME 04551-3401 |
Second Address | Bremen, ME 04551-3401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2015 |
Last Update Date | 19/11/2015 |