Provider Demographics
NPI:1700040052
Name:MAIELLA, EMILY C (ND)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:C
Last Name:MAIELLA
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 1:13 LADY SLIPPER LN
Mailing Address - Street 2:
Mailing Address - City:WENDELL
Mailing Address - State:MA
Mailing Address - Zip Code:01379-7926
Mailing Address - Country:US
Mailing Address - Phone:413-230-4462
Mailing Address - Fax:978-544-0240
Practice Address - Street 1:1063 MARLBORO RD
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05301-9733
Practice Address - Country:US
Practice Address - Phone:413-230-4462
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0990000233175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath