Provider Demographics
NPI:1336693464
Name:HANLEY, INDIA (ND)
Entity Type:Individual
Prefix:DR
First Name:INDIA
Middle Name:
Last Name:HANLEY
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 1:9403 N 55TH ST
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-1654
Mailing Address - Country:US
Mailing Address - Phone:480-900-2222
Mailing Address - Fax:480-382-2932
Practice Address - Street 1:16601 N 90TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2788
Practice Address - Country:US
Practice Address - Phone:480-462-2222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-05
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16-1556175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ16-1556OtherNATUROPATHIC PHYSICIAN