MEDICARE: WINDHORSE NATUROPATHIC INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath	0990000233	VT

General Provider Information

NPI Number	:	1356708770
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WINDHORSE NATUROPATHIC INC

Provider Business Mailing Address
First Line	:	13 LADY SLIPPER LN
Second Line	:
City	:	WENDELL
State	:	MA
Zip	:	01379-7926
Country	:	US
Telephone Number	:	978-544-5459
Fax Number	:

Provider Business Practice Location Address
First Line	:	63 WESTERN AVE
Second Line	:
City	:	BRATTLEBORO
State	:	VT
Zip	:	05301-6093
Country	:	US
Telephone Number	:	802-246-4282
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. EMILY MAIELLA
Credential	:	ND
Telephone Number	:	978-544-5459

Provider Enumeration Date	:	01/16/2016
Last Update Date	:	01/16/2016

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