Provider Demographics
NPI:1427179571
Name:POWELL, DONNA M (ND,LAC)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:M
Last Name:POWELL
Suffix:
Gender:F
Credentials:ND,LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-8407
Mailing Address - Country:US
Mailing Address - Phone:802-863-7099
Mailing Address - Fax:802-863-8713
Practice Address - Street 1:33 MAIN ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-8407
Practice Address - Country:US
Practice Address - Phone:802-863-7099
Practice Address - Fax:802-863-8713
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099-0000003175F00000X
VT171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered175F00000XOther Service ProvidersNaturopath
Not Answered171100000XOther Service ProvidersAcupuncturist