Provider Demographics
NPI:1730308966
Name:CRONIN, COURTNEY ELYSON (NMD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:ELYSON
Last Name:CRONIN
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 1:2141 E. WARNER RD.
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284
Mailing Address - Country:US
Mailing Address - Phone:480-361-5188
Mailing Address - Fax:480-304-3208
Practice Address - Street 1:2141 E. WARNER RD
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284
Practice Address - Country:US
Practice Address - Phone:480-361-5188
Practice Address - Fax:480-304-3208
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ06-957175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath