Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND-433 | CA |
NPI | 1013244383 |
---|---|
Provider Name | Amanda Marie Frick |
First Address | Santa Monica, CA 90401-1872 |
Second Address | Santa Monica, CA 90401-1872 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2009 |
Last Update Date | 30/04/2012 |