Provider Demographics
NPI:1740433879
Name:DICKENS, ANDREW FORBES (NMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:FORBES
Last Name:DICKENS
Suffix:
Gender:M
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2133 E WARNER RD
Mailing Address - Street 2:STE. 102
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-3492
Mailing Address - Country:US
Mailing Address - Phone:480-820-6695
Mailing Address - Fax:
Practice Address - Street 1:2133 E WARNER RD
Practice Address - Street 2:STE. 102
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-3492
Practice Address - Country:US
Practice Address - Phone:480-820-6695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ08-1082175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath