Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 17-1677 | AZ |
NPI | 1083125025 |
---|---|
Provider Name | Jessica Leigh Folz |
First Address | Glendale, AZ 85310-5227 |
Second Address | Phoenix, AZ 85018-9183 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2017 |
Last Update Date | 23/07/2021 |