Provider Demographics
NPI:1679170831
Name:BAAYEH, HARRIET
Entity Type:Individual
Prefix:DR
First Name:HARRIET
Middle Name:
Last Name:BAAYEH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 E MALIBU DR
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-5768
Mailing Address - Country:US
Mailing Address - Phone:215-429-2453
Mailing Address - Fax:
Practice Address - Street 1:4657 S LAKESHORE DR STE 1
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-7170
Practice Address - Country:US
Practice Address - Phone:480-284-8155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20-1909175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath