Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 98-555 | AZ |
NPI | 1083746051 |
---|---|
Provider Name | Teresa Vesco |
First Address | Scottsdale, AZ 85254-1256 |
Second Address | Scottsdale, AZ 85254-1256 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 08/07/2007 |