Provider Demographics
NPI:1194223552
Name:PLACELLA, NAOMI ELIZABETH (NMD)
Entity type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:ELIZABETH
Last Name:PLACELLA
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 W WARNER RD STE C3
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-2915
Mailing Address - Country:US
Mailing Address - Phone:480-732-7401
Mailing Address - Fax:480-588-6934
Practice Address - Street 1:604 W WARNER RD STE C3
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225
Practice Address - Country:US
Practice Address - Phone:480-999-4230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-30
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18-1693175F00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No175F00000XOther Service ProvidersNaturopath