Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 18-1736 | AZ |
NPI | 1134603210 |
---|---|
Provider Name | Dr. Morgan Leigh Massingale |
First Address | Tempe, AZ 85282-1766 |
Second Address | Tempe, AZ 85282-1766 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2018 |
Last Update Date | 24/09/2018 |