Provider Demographics
NPI:1073155677
Name:TAKEUCHI MILLER, EMILY IRIS ANGELA (ND)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:IRIS ANGELA
Last Name:TAKEUCHI MILLER
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 1:2028 E PRINCE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719
Mailing Address - Country:US
Mailing Address - Phone:520-209-1755
Mailing Address - Fax:520-798-2468
Practice Address - Street 1:2028 E PRINCE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719
Practice Address - Country:US
Practice Address - Phone:520-209-1755
Practice Address - Fax:520-798-2468
Is Sole Proprietor?:No
Enumeration Date:2019-10-15
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1101175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath