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General NPI Number Information
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NPI Number | 1295319994
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Entity Type | Individual
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Provider Name | ADRIANA SUSANA BERUSCH GERARDINO NMD
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Gender | Female
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Dates
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Enumeration Date | 05/08/2021
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Last Update Date | 05/23/2023
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Provider Practice Location Address
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Address Line | 702 W 12TH PL
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City | TEMPE
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State | AZ
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Zip | 85281-5419
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Country | US
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Telephone | 480-420-4827
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Fax |
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Provider Business Mailing Address
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Address Line | 702 W 12TH PL
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City | TEMPE
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State | AZ
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Zip | 85281-5419
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Country | US
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Telephone | 480-420-4827
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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 | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 21-1948
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License Number State | AZ
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