Provider Demographics
NPI:1336511278
Name:NORONHA, BETHANIA MARINA (ND)
Entity Type:Individual
Prefix:DR
First Name:BETHANIA
Middle Name:MARINA
Last Name:NORONHA
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 1:9312 E RAINTREE DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2094
Mailing Address - Country:US
Mailing Address - Phone:480-779-7755
Mailing Address - Fax:
Practice Address - Street 1:9312 E RAINTREE DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2094
Practice Address - Country:US
Practice Address - Phone:480-779-7755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15-1509175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath