Healthcare Provider Details

I. General information

NPI: 1427458975
Provider Name (Legal Business Name): NATUROPATHIC WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2014
Last Update Date: 09/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 SANFORD ST
HAMDEN CT
06514-1723
US

IV. Provider business mailing address

105 SANFORD ST
HAMDEN CT
06514-1723
US

V. Phone/Fax

Practice location:
  • Phone: 475-227-2773
  • Fax: 475-227-2384
Mailing address:
  • Phone: 475-227-2773
  • Fax: 475-227-2384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number502
License Number StateCT

VIII. Authorized Official

Name: DR. LISA LAUGHLIN
Title or Position: OWNER/PHYSICIAN
Credential: ND
Phone: 475-227-2773