Provider Demographics
NPI:1396979142
Name:DOAK, EMILIE FRIEDERIKE (NMD)
Entity type:Individual
Prefix:DR
First Name:EMILIE
Middle Name:FRIEDERIKE
Last Name:DOAK
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 1:12220 N 112TH AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGTOWN
Mailing Address - State:AZ
Mailing Address - Zip Code:85363-1204
Mailing Address - Country:US
Mailing Address - Phone:480-264-4833
Mailing Address - Fax:
Practice Address - Street 1:16425 E PALISADES BLVD
Practice Address - Street 2:105
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-3754
Practice Address - Country:US
Practice Address - Phone:480-837-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ07-1010175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath