Healthcare Provider Details
I. General information
NPI: 1427838523
Provider Name (Legal Business Name): AMANDA DANIELLA GARCIA ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/05/2023
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
346 SHELBURNE RD STE 402
BURLINGTON VT
05401-4935
US
IV. Provider business mailing address
365 SAINT PAUL ST APT 6
BURLINGTON VT
05401-4649
US
V. Phone/Fax
- Phone: 802-238-8603
- Fax: 855-886-6950
- Phone: 929-928-7634
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175F00000X |
| Taxonomy | Naturopath |
| License Number | 099.0134222 |
| License Number State | VT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: