Provider Demographics
NPI:1952647067
Name:CARLE, KIRSTEN LEANNE (ND)
Entity Type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:LEANNE
Last Name:CARLE
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 1:20 HUCKLEBERRY LN
Mailing Address - Street 2:
Mailing Address - City:WEST HURLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12491-5156
Mailing Address - Country:US
Mailing Address - Phone:845-532-9777
Mailing Address - Fax:
Practice Address - Street 1:530 MAIN ST
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:VT
Practice Address - Zip Code:05201-2169
Practice Address - Country:US
Practice Address - Phone:802-445-3152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099.0091571175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath