Healthcare Provider Details

I. General information

NPI: 1942480777
Provider Name (Legal Business Name): JENNIFER LEE DYE NMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2007
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10210 N 32ND ST STE C5
PHOENIX AZ
85028-3826
US

IV. Provider business mailing address

10210 N 32ND ST STE C5
PHOENIX AZ
85028-3826
US

V. Phone/Fax

Practice location:
  • Phone: 480-448-8888
  • Fax: 844-391-7650
Mailing address:
  • Phone: 480-448-8888
  • Fax: 844-391-7650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number09-1160
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: