Provider Demographics
NPI:1689995920
Name:FERREIRA, KRISTIE A (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:KRISTIE
Middle Name:A
Last Name:FERREIRA
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 1:391 S UNION ST
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-2824
Mailing Address - Country:US
Mailing Address - Phone:203-671-2813
Mailing Address - Fax:203-458-1597
Practice Address - Street 1:391 S UNION ST
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437-2824
Practice Address - Country:US
Practice Address - Phone:203-671-2813
Practice Address - Fax:203-458-1597
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000414175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath