Healthcare Provider Details

I. General information

NPI: 1235271818
Provider Name (Legal Business Name): SIBONGILE MNGUNI N.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SIBONGILE VERRETT N.D

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 11/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3444 N COUNTRY CLUB RD 120
TUCSON AZ
85716-1200
US

IV. Provider business mailing address

7850 N SILVERBELL RD 114-257
TUCSON AZ
85743-8219
US

V. Phone/Fax

Practice location:
  • Phone: 520-999-3707
  • Fax: 520-999-3706
Mailing address:
  • Phone: 602-373-9526
  • Fax: 520-999-3706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number3201
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number09-1169
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: