Provider Demographics
NPI:1992464945
Name:CHATFIELD, REBECCA (ND)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:CHATFIELD
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:824 W GURLEY ST APT 202
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-3646
Mailing Address - Country:US
Mailing Address - Phone:909-967-2849
Mailing Address - Fax:
Practice Address - Street 1:140 N GRANITE ST
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-3002
Practice Address - Country:US
Practice Address - Phone:928-298-3349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1302175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath