Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ND-364 | CA |
NPI | 1093942716 |
---|---|
Provider Name | Valerie Marianne Phillips |
First Address | Los Angeles, CA 90039-1804 |
Second Address | Los Angeles, CA 90039-1804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2009 |
Last Update Date | 17/11/2009 |