Healthcare Provider Details

I. General information

NPI: 1326451956
Provider Name (Legal Business Name): MARIA GABRIELLE N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 06/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 CONDESA RD
SANTA FE NM
87508-2333
US

IV. Provider business mailing address

17 CONDESA RD
SANTA FE NM
87508-2333
US

V. Phone/Fax

Practice location:
  • Phone: 505-438-4848
  • Fax: 505-438-4848
Mailing address:
  • Phone: 505-438-4848
  • Fax: 505-438-4848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: