Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath |
NPI | 1073879292 |
---|---|
Provider Name | Dr. Dana Shelley Michaels |
First Address | Santa Rosa, CA 95403-1475 |
Second Address | Santa Rosa, CA 95403-8217 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2012 |
Last Update Date | 02/04/2012 |