Provider Demographics
NPI:1164622668
Name:WHITTINGTON, AMY LEANNE (NMD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:LEANNE
Last Name:WHITTINGTON
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 1:4080 W HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-2160
Mailing Address - Country:US
Mailing Address - Phone:602-770-1071
Mailing Address - Fax:480-902-0753
Practice Address - Street 1:27980 N TRILOGY BLVD STE 102
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-4202
Practice Address - Country:US
Practice Address - Phone:623-215-6290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ03-751175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath