Provider Demographics
NPI:1700139425
Name:TESSIER, LAUREN MICHELLE (ND)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:MICHELLE
Last Name:TESSIER
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 1:46 S MAIN ST
Mailing Address - Street 2:#2
Mailing Address - City:WATERBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05676-1812
Mailing Address - Country:US
Mailing Address - Phone:802-560-5594
Mailing Address - Fax:802-882-8157
Practice Address - Street 1:46 S MAIN ST
Practice Address - Street 2:SUITE #2
Practice Address - City:WATERBURY
Practice Address - State:VT
Practice Address - Zip Code:05676-1812
Practice Address - Country:US
Practice Address - Phone:802-560-5594
Practice Address - Fax:802-882-8157
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT099.0090782175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1021422Medicaid