Provider Demographics
NPI:1851412027
Name:BOVE, MARY LOUISE (ND)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:LOUISE
Last Name:BOVE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1063 MARLBORO ROAD
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05301-9733
Mailing Address - Country:US
Mailing Address - Phone:802-254-9332
Mailing Address - Fax:802-258-2629
Practice Address - Street 1:1063 MARLBORO ROAD
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:802-254-9332
Practice Address - Fax:802-258-2629
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT009-0000004175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath