Provider Demographics
NPI:1003280611
Name:LACLAIR, JOELLE HAYNES (ND)
Entity Type:Individual
Prefix:DR
First Name:JOELLE
Middle Name:HAYNES
Last Name:LACLAIR
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 STORER RD
Mailing Address - Street 2:
Mailing Address - City:BREMEN
Mailing Address - State:ME
Mailing Address - Zip Code:04551-3401
Mailing Address - Country:US
Mailing Address - Phone:207-751-6762
Mailing Address - Fax:
Practice Address - Street 1:98 STORER RD
Practice Address - Street 2:
Practice Address - City:BREMEN
Practice Address - State:ME
Practice Address - Zip Code:04551-3401
Practice Address - Country:US
Practice Address - Phone:207-751-6762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MENP301175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath