Provider Demographics
NPI:1972883866
Name:ALDRICH, PATRICIA (DN, LMT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:ALDRICH
Suffix:
Gender:F
Credentials:DN, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1971 W SILVERBELL RD
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48359-1248
Mailing Address - Country:US
Mailing Address - Phone:248-393-8633
Mailing Address - Fax:
Practice Address - Street 1:1971 W SILVERBELL RD
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48359-1248
Practice Address - Country:US
Practice Address - Phone:248-393-8633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ62262108175F00000X
225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No175F00000XOther Service ProvidersNaturopath