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General NPI Number Information
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NPI Number | 1598689085
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Entity Type | Individual
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Provider Name | ALEXANDRA JOHNSON AVERILL ND
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Gender | Female
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 41 IDX DR STE 220
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City | SOUTH BURLINGTON
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State | VT
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Zip | 05403-7781
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Country | US
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Telephone | 802-448-3388
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Fax | 802-448-3387
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Provider Business Mailing Address
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Address Line | 65 WINOOSKI FALLS WAY APT 311
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City | WINOOSKI
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State | VT
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Zip | 05404-2261
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Country | US
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Telephone | 802-448-3388
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Fax | 802-448-3387
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 |
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License Number State | VT
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