Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 19-1791 | AZ |
NPI | 1134681380 |
---|---|
Provider Name | Dr. Mariah Ellen Mosley |
First Address | Tucson, AZ 85742-4329 |
Second Address | Tucson, AZ 85742 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2019 |
Last Update Date | 04/04/2019 |