Provider Demographics
NPI:1396029534
Name:DEVILLE, LAUREN (NMD)
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:
Last Name:DEVILLE
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 1:180 W MAGEE RD #116
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704
Mailing Address - Country:US
Mailing Address - Phone:520-261-5790
Mailing Address - Fax:855-350-5609
Practice Address - Street 1:180 W MAGEE RD #116
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704
Practice Address - Country:US
Practice Address - Phone:520-887-4287
Practice Address - Fax:520-887-0100
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11-1260175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath