Provider Demographics
NPI:1215247374
Name:GIRARD-DICARLO, JENEVE MICHELLE (ND)
Entity type:Individual
Prefix:DR
First Name:JENEVE
Middle Name:MICHELLE
Last Name:GIRARD-DICARLO
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 1:28 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-3166
Mailing Address - Country:US
Mailing Address - Phone:802-262-1012
Mailing Address - Fax:802-262-1085
Practice Address - Street 1:28 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-3166
Practice Address - Country:US
Practice Address - Phone:802-262-1012
Practice Address - Fax:802-262-1085
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0990070976175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath