Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 90-0408 | AZ |
NPI | 1073944112 |
---|---|
Provider Name | Marianne Calvanese |
First Address | Austin, TX 78704-3368 |
Second Address | Austin, TX 78704-3368 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2013 |
Last Update Date | 03/12/2013 |