Healthcare Provider Details

I. General information

NPI: 1053460154
Provider Name (Legal Business Name): KAREN LORRAINE FREEZE NM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 12/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9221 S SAN PABLO DR
GOODYEAR AZ
85338-9320
US

IV. Provider business mailing address

9221 S SAN PABLO DR
GOODYEAR AZ
85338-9320
US

V. Phone/Fax

Practice location:
  • Phone: 623-824-9600
  • Fax: 623-399-6919
Mailing address:
  • Phone: 623-824-9600
  • Fax: 623-399-6919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number03--778
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: