Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 18-1751 | AZ |
NPI | 1083199400 |
---|---|
Provider Name | Lynnea Felton |
First Address | Scottsdale, AZ 85257-4176 |
Second Address | Tempe, AZ 85282-1751 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2018 |
Last Update Date | 02/10/2018 |