Provider Demographics
NPI:1174750525
Name:KENT, AISHA ROSE (MSOM,BA,LAC)
Entity type:Individual
Prefix:MISS
First Name:AISHA
Middle Name:ROSE
Last Name:KENT
Suffix:
Gender:F
Credentials:MSOM,BA,LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:223 SENECA CREEK RD
Mailing Address - Street 2:
Mailing Address - City:HINESBURG
Mailing Address - State:VT
Mailing Address - Zip Code:05461-9580
Mailing Address - Country:US
Mailing Address - Phone:802-777-7817
Mailing Address - Fax:
Practice Address - Street 1:257 S CHAMPLAIN ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-4717
Practice Address - Country:US
Practice Address - Phone:802-777-7817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT091.0114027171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist