Healthcare Provider Details

I. General information

NPI: 1972425213
Provider Name (Legal Business Name): NATURAL BORN HEALER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13802 N SCOTTSDALE RD STE 120
SCOTTSDALE AZ
85254-3460
US

IV. Provider business mailing address

1033 E KERRY LN
PHOENIX AZ
85024-2309
US

V. Phone/Fax

Practice location:
  • Phone: 602-206-8947
  • Fax:
Mailing address:
  • Phone: 602-206-8947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: KADIDRAH JAFFAR
Title or Position: MASSAGE THERAPIST
Credential: LMT
Phone: 602-206-8947