Provider Demographics
NPI:1407259336
Name:WILLIAMSON, KAYLEE DENAE (NMD)
Entity Type:Individual
Prefix:DR
First Name:KAYLEE
Middle Name:DENAE
Last Name:WILLIAMSON
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 1:3231 S COUNTRY CLUB WAY STE 106
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-4053
Mailing Address - Country:US
Mailing Address - Phone:480-820-5026
Mailing Address - Fax:
Practice Address - Street 1:3231 S COUNTRY CLUB WAY
Practice Address - Street 2:SUITE 106
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-4053
Practice Address - Country:US
Practice Address - Phone:480-820-5026
Practice Address - Fax:520-333-3206
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14-1458175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath