Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 14-1441 | AZ |
NPI | 1063816130 |
---|---|
Provider Name | Dr. Hayley Collinge |
First Address | Mesa, AZ 85210-4981 |
Second Address | Gilbert, AZ 85234-2407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2014 |
Last Update Date | 17/03/2018 |