Provider Demographics
NPI:1275327033
Name:CAVALCANTE RIBEIRO, THIAGO
Entity type:Individual
Prefix:
First Name:THIAGO
Middle Name:
Last Name:CAVALCANTE RIBEIRO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 E PRINCESS DR APT 1017
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5807
Mailing Address - Country:US
Mailing Address - Phone:480-247-1705
Mailing Address - Fax:
Practice Address - Street 1:8952 E DESERT COVE AVE STE 208
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6777
Practice Address - Country:US
Practice Address - Phone:480-771-4422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25-1922175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath