Healthcare Provider Details

I. General information

NPI: 1720409907
Provider Name (Legal Business Name): KALEAH DUVAL ND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2013
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 S MAIN ST
STOWE VT
05672-4595
US

IV. Provider business mailing address

645 S MAIN ST
STOWE VT
05672-4595
US

V. Phone/Fax

Practice location:
  • Phone: 802-253-2340
  • Fax: 802-253-2239
Mailing address:
  • Phone: 802-253-2340
  • Fax: 802-253-2239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number099.0134288
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: