Healthcare Provider Details

I. General information

NPI: 1164008603
Provider Name (Legal Business Name): MARESHAH DUNNING NMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 07/28/2022
Certification Date: 07/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2152 E BROADWAY RD
TEMPE AZ
85282-1751
US

IV. Provider business mailing address

2150 S CHOLLA
MESA AZ
85202-6503
US

V. Phone/Fax

Practice location:
  • Phone: 480-970-0000
  • Fax: 480-970-0003
Mailing address:
  • Phone: 310-918-2955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number20-1938
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: