Healthcare Provider Details

I. General information

NPI: 1598193419
Provider Name (Legal Business Name): DAYNA MONTERREY N.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2013
Last Update Date: 10/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4701 S LAKESHORE DR STE 3
TEMPE AZ
85282-7169
US

IV. Provider business mailing address

4701 S LAKESHORE DR STE 3
TEMPE AZ
85282-7169
US

V. Phone/Fax

Practice location:
  • Phone: 480-718-9493
  • Fax:
Mailing address:
  • Phone: 480-718-9493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number13-1388
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: