Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND1098 | CA |
NPI | 1043852650 |
---|---|
Provider Name | Dr. Stacey Leigh Mclarry |
First Address | San Diego, CA 92107-3408 |
Second Address | San Diego, CA 92107-3408 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2019 |
Last Update Date | 15/10/2019 |