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General NPI Number Information
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NPI Number | 1467696039
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Entity Type | Organization
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Legal Business Name | CONNECTICUT NATURAL HEALTH SPECIALISTS LLC
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Dates
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Enumeration Date | 04/27/2009
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Last Update Date | 05/21/2009
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Provider Practice Location Address
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Address Line | 25 CONCORD ST
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City | GLASTONBURY
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State | CT
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Zip | 06033-2135
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Country | US
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Telephone | 860-428-0535
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Fax |
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Provider Business Mailing Address
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Address Line | 25 CONCORD ST
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City | GLASTONBURY
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State | CT
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Zip | 06033-2135
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Country | US
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Telephone | 860-428-0535
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LAUREN J GOUIN
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Credential | ND
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Telephone | 860-428-0535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 000397
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License Number State | CT
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