Provider Demographics
NPI:1336416262
Name:DOOLEY, MELONNI ANN (NMD)
Entity Type:Individual
Prefix:DR
First Name:MELONNI
Middle Name:ANN
Last Name:DOOLEY
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 1:2543 E SWEETWATER AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-6926
Mailing Address - Country:US
Mailing Address - Phone:704-234-7644
Mailing Address - Fax:704-919-5671
Practice Address - Street 1:2543 E SWEETWATER AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-6926
Practice Address - Country:US
Practice Address - Phone:704-234-7644
Practice Address - Fax:704-919-5671
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-21
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11-1274175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath