Provider Demographics
NPI:1518173715
Name:BRAINERD, ELIZABETH E (ND)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:E
Last Name:BRAINERD
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 1:35 BOSTON ST
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2817
Mailing Address - Country:US
Mailing Address - Phone:203-738-0020
Mailing Address - Fax:203-453-5684
Practice Address - Street 1:35 BOSTON ST
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2817
Practice Address - Country:US
Practice Address - Phone:203-738-0020
Practice Address - Fax:203-453-5684
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT237175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath