Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath |
NPI | 1003412784 |
---|---|
Provider Name | Dr. Tonya Marie Houghton |
First Address | Lady Lake, FL 32159-4346 |
Second Address | Lady Lake, FL 32159-4346 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2020 |
Last Update Date | 08/12/2020 |