Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 20-1896 | AZ |
NPI | 1053911289 |
---|---|
Provider Name | Elizabeth Shaw |
First Address | Chandler, AZ 85226-4458 |
Second Address | Chandler, AZ 85226-4458 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2020 |
Last Update Date | 27/10/2020 |