Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 151486 | AZ |
NPI | 1023404266 |
---|---|
Provider Name | Michelle Y. Mcconnell |
First Address | Phoenix, AZ 85032-5613 |
Second Address | Phoenix, AZ 85032-5613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2015 |
Last Update Date | 08/01/2016 |