Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath |
NPI | 1205476579 |
---|---|
Provider Name | Danielle Andersen |
First Address | Phoenix, AZ 85016-4126 |
Second Address | Scottsdale, AZ 85255-7456 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2020 |
Last Update Date | 03/03/2020 |