Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 605 | |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 605 | |
N | 101YP2500X | Professional Counselor | 605 | |
N | 175L00000X | Homeopath |
NPI | 1932324647 |
---|---|
Provider Name | Vimal Patel |
First Address | Scottsdale, AZ 85260-2827 |
Second Address | Scottsdale, AZ 85260 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 13/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S009492 | STATE BOARD OF PHARMACY (01) | AZ |