Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath |
NPI | 1003218033 |
---|---|
Provider Name | Michele Burklund |
First Address | Ojai, CA 93023-2956 |
Second Address | Ojai, CA 93023-2956 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2014 |
Last Update Date | 22/09/2014 |