Provider Demographics
NPI:1952716128
Name:BEITEL, SUE ROSARIO (NMD)
Entity Type:Individual
Prefix:DR
First Name:SUE
Middle Name:ROSARIO
Last Name:BEITEL
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 1:10010 N 52ND ST
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-1022
Mailing Address - Country:US
Mailing Address - Phone:508-922-2392
Mailing Address - Fax:
Practice Address - Street 1:10010 N 52ND ST
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-1022
Practice Address - Country:US
Practice Address - Phone:508-922-2392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-26
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14-1439175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath