Provider Demographics
NPI:1043812480
Name:STYNCHULA, ANDEE R (ND)
Entity Type:Individual
Prefix:DR
First Name:ANDEE
Middle Name:R
Last Name:STYNCHULA
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ELM ST STE 1
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04038-1506
Mailing Address - Country:US
Mailing Address - Phone:207-604-2236
Mailing Address - Fax:207-805-6470
Practice Address - Street 1:8 ELM ST STE 1
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:ME
Practice Address - Zip Code:04038-1506
Practice Address - Country:US
Practice Address - Phone:207-604-2236
Practice Address - Fax:207-805-6470
Is Sole Proprietor?:No
Enumeration Date:2020-11-11
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MENP705175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath