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Contact Information

ICU423R
1101 W GUADALUPE RD STE 1
MESA, AZ85210-7601
 Phone: 480-788-5621
 Fax: 480-779-1277
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Integrative Medicine

202D00000X
 

Community/Behavioral Health

251S00000X
Indicates primary specialty

NPI Profile & details for ICU423R · (Female)

NPI # 1528752300
Status Active
Credentials
Entity Individual
Enumeration date 06/06/2023
Last updated 06/06/2023 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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