Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 15-1501 | AZ |
NPI | 1134591159 |
---|---|
Provider Name | Elizabeth Livengood-Anderson |
First Address | Phoenix, AZ 85016-7146 |
Second Address | Phoenix, AZ 85016-7146 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2015 |
Last Update Date | 29/10/2015 |