Provider Demographics
NPI:1528385952
Name:GAJUS, STEPHANIE (NMD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:GAJUS
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 1:8575 E PRINCESS DR
Mailing Address - Street 2:SUITE 111
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5483
Mailing Address - Country:US
Mailing Address - Phone:480-515-3600
Mailing Address - Fax:480-538-0200
Practice Address - Street 1:8575 E PRINCESS DR
Practice Address - Street 2:SUITE 111
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-5483
Practice Address - Country:US
Practice Address - Phone:480-515-3600
Practice Address - Fax:480-538-0200
Is Sole Proprietor?:No
Enumeration Date:2010-04-25
Last Update Date:2010-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ09-1152175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath