Provider Demographics
NPI:1790983039
Name:MUNOZ, BIANCA DACANAY (NMD)
Entity Type:Individual
Prefix:DR
First Name:BIANCA
Middle Name:DACANAY
Last Name:MUNOZ
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 1:4215 E MCDOWELL RD STE 115
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85215-9744
Mailing Address - Country:US
Mailing Address - Phone:480-304-4355
Mailing Address - Fax:
Practice Address - Street 1:4215 E MCDOWELL RD
Practice Address - Street 2:#115
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85215-0001
Practice Address - Country:US
Practice Address - Phone:480-304-4955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-09
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ06-954175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath