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General NPI Number Information
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NPI Number | 1134086614
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Entity Type | Individual
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Provider Name | KELSEY MATTAS DACHM, LAC
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Gender | Female
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 3115 E INDIAN SCHOOL RD # 42&63
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City | PHOENIX
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State | AZ
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Zip | 85016-6807
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Country | US
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Telephone | 480-375-1074
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Fax |
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Provider Business Mailing Address
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Address Line | 1666 S EXTENSION RD APT 12-208
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City | MESA
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State | AZ
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Zip | 85210-9339
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Country | US
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Telephone | 850-585-9131
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 012222
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License Number State | AZ
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