Provider Demographics
NPI:1992257802
Name:BRIANTE, CARLA LOUISE (NMD)
Entity type:Individual
Prefix:DR
First Name:CARLA
Middle Name:LOUISE
Last Name:BRIANTE
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 1:455 S MESA DR
Mailing Address - Street 2:UNIT 157
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-2597
Mailing Address - Country:US
Mailing Address - Phone:480-648-7793
Mailing Address - Fax:
Practice Address - Street 1:1641 E OSBORN RD
Practice Address - Street 2:SUITE 6
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7146
Practice Address - Country:US
Practice Address - Phone:602-265-1774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16-1580175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath