Provider Demographics
NPI:1790245629
Name:ST. CLAIR, JULIA (NMD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:ST. CLAIR
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 1:639 E IVANHOE ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-3985
Mailing Address - Country:US
Mailing Address - Phone:530-338-1774
Mailing Address - Fax:480-923-6595
Practice Address - Street 1:1543 W ELLIOT RD STE 104
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-5170
Practice Address - Country:US
Practice Address - Phone:480-571-0305
Practice Address - Fax:480-923-6595
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-25
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19-1780175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath