Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 000451 | CT |
NPI | 1104114438 |
---|---|
Provider Name | Summer D Mcallister |
First Address | Norwalk, CT 06851-4903 |
Second Address | Norwalk, CT 06851-4903 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2011 |
Last Update Date | 19/10/2011 |