Provider Demographics
NPI:1205176351
Name:VAELLI, BARBARA BLUNT
Entity type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:BLUNT
Last Name:VAELLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 KIMBARK ST
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-8008
Mailing Address - Country:US
Mailing Address - Phone:720-652-9972
Mailing Address - Fax:
Practice Address - Street 1:736 KIMBARK ST
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-8008
Practice Address - Country:US
Practice Address - Phone:720-652-9972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-27
Last Update Date:2013-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO785171100000X
WANT 00001079175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist