Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 05-895 | AZ |
NPI | 1144557745 |
---|---|
Provider Name | Dr. Allison Ivy Mcdaniel |
First Address | Phoenix, AZ 85028-1102 |
Second Address | Phoenix, AZ 85028-1102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2009 |
Last Update Date | 03/11/2009 |