Healthcare Provider Details

I. General information

NPI: 1548682107
Provider Name (Legal Business Name): HEATHER MARIE CRIDER N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2014
Last Update Date: 03/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11518 E APACHE TRL STE 117
APACHE JUNCTION AZ
85120-3531
US

IV. Provider business mailing address

19 1/2 HILL AVE
ORLANDO FL
32801-2926
US

V. Phone/Fax

Practice location:
  • Phone: 480-788-1629
  • Fax:
Mailing address:
  • Phone: 407-883-7444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1712
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: