Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 01-611 | AZ |
NPI | 1093927477 |
---|---|
Provider Name | Cheryl Marie Deroin |
First Address | Scottsdale, AZ 85258-3188 |
Second Address | Scottsdale, AZ 85258-3188 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2007 |
Last Update Date | 08/07/2007 |