Provider Demographics
NPI:1528675832
Name:LATTANZA, LAUREN VICTORIA (NMD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:VICTORIA
Last Name:LATTANZA
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 1:10585 N TATUM BLVD STE D135
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-1073
Mailing Address - Country:US
Mailing Address - Phone:480-535-6844
Mailing Address - Fax:480-535-6845
Practice Address - Street 1:10585 N TATUM BLVD STE D135
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-1073
Practice Address - Country:US
Practice Address - Phone:480-535-6844
Practice Address - Fax:480-535-6845
Is Sole Proprietor?:No
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20-1903175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath