Provider Demographics
NPI:1447546163
Name:LUMENELLO, CATHERINE JEAN (DAC, LAC)
Entity type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:JEAN
Last Name:LUMENELLO
Suffix:
Gender:X
Credentials:DAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DEPOT RD
Mailing Address - Street 2:
Mailing Address - City:TOWNSHEND
Mailing Address - State:VT
Mailing Address - Zip Code:05353-9732
Mailing Address - Country:US
Mailing Address - Phone:802-365-4885
Mailing Address - Fax:
Practice Address - Street 1:10 DEPOT RD
Practice Address - Street 2:
Practice Address - City:TOWNSHEND
Practice Address - State:VT
Practice Address - Zip Code:05353-9732
Practice Address - Country:US
Practice Address - Phone:802-365-4885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0462171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist