Provider Demographics
NPI:1922575786
Name:LIMA, PAULA (NMD)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:
Last Name:LIMA
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 1:3160 W CARLOS LN
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-3015
Mailing Address - Country:US
Mailing Address - Phone:602-565-2326
Mailing Address - Fax:
Practice Address - Street 1:2601 N 3RD ST STE 304
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1193
Practice Address - Country:US
Practice Address - Phone:602-908-5422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-30
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ18-1755175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath