Provider Demographics
NPI:1467706572
Name:LOFARO, LINDA MARIE (LIC ACP MAOM)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:MARIE
Last Name:LOFARO
Suffix:
Gender:F
Credentials:LIC ACP MAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7878 E GAINEY RANCH RD UNIT 53
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-1770
Mailing Address - Country:US
Mailing Address - Phone:480-689-5949
Mailing Address - Fax:
Practice Address - Street 1:7878 E GAINEY RANCH RD UNIT 53
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-1770
Practice Address - Country:US
Practice Address - Phone:480-689-5949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-29
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0901171100000X
MA253924171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist