Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 01-659 | AZ |
NPI | 1063688455 |
---|---|
Provider Name | Dr. Susan M Williams |
First Address | Phoenix, AZ 85006-2664 |
Second Address | Phoenix, AZ 85006-2664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2008 |
Last Update Date | 05/05/2008 |