Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath |
NPI | 1053655845 |
---|---|
Provider Name | Allison Svobodny |
First Address | Moorhead, MN 56560 |
Second Address | Moorhead, MN 56560 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2012 |
Last Update Date | 16/11/2012 |