Provider Demographics
NPI:1831517036
Name:DARDEN, NAOMI
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:DARDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DR NAOMI
Other - Middle Name:
Other - Last Name:DARDEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:25711 SOUTHFIELD RD
Mailing Address - Street 2:206
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-1875
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:25711 SOUTHFIELD RD
Practice Address - Street 2:206
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-1875
Practice Address - Country:US
Practice Address - Phone:313-828-9355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X174400000X
MI175F00000X175F00000X
MI175L00000X175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No175F00000XOther Service ProvidersNaturopath
No175L00000XOther Service ProvidersHomeopath