Healthcare Provider Details

I. General information

NPI: 1699502666
Provider Name (Legal Business Name): CAROL A RAINVILLE ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 09/16/2024
Certification Date: 09/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 VILLAGE GREEN RD APT E5
HAMPSTEAD NH
03841-2256
US

IV. Provider business mailing address

52 VILLAGE GREEN RD APT E5
HAMPSTEAD NH
03841-2256
US

V. Phone/Fax

Practice location:
  • Phone: 617-699-0812
  • Fax:
Mailing address:
  • Phone: 617-699-0812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: