Provider Demographics
NPI:1417107095
Name:HEALY, MARIE ANTOINTEET (L AC, MSOM)
Entity Type:Individual
Prefix:MS
First Name:MARIE
Middle Name:ANTOINTEET
Last Name:HEALY
Suffix:
Gender:F
Credentials:L AC, MSOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 INCHCLIFFE DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:GALES FERRY
Mailing Address - State:CT
Mailing Address - Zip Code:06335-1807
Mailing Address - Country:US
Mailing Address - Phone:860-908-7078
Mailing Address - Fax:860-237-5189
Practice Address - Street 1:1 INCHCLIFFE DR
Practice Address - Street 2:SUITE D
Practice Address - City:GALES FERRY
Practice Address - State:CT
Practice Address - Zip Code:06335-1807
Practice Address - Country:US
Practice Address - Phone:860-908-7078
Practice Address - Fax:860-237-5189
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT368171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist