MAA WELLNESS CENTER NPI 1366094393

NPI Information

NPI: 1366094393
Provider Name: MAA WELLNESS CENTER
Classification: Nutritionist - 133NN1002X
Entity Type: Organization

Specialization: Nutrition, Education

CLIA Number: 03D2220156

Address:
3146 E WIER AVE RM 19
PHOENIX, AZ
ZIP 85040
Phone: (602) 305-4719
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MAA WELLNESS CENTER is a nutrition and education nutritionist in Phoenix, AZ. MAA WELLNESS CENTER NPI is 1366094393. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3146 E WIER AVE RM 19
PHOENIX, AZ
ZIP 85040-754
Phone: (602) 305-4719

The provider's authorized official is Angela Gragg .
The authorized official title is President and has the following contact phone number (602) 305-4719.

The CLIA number assigned to this NPI record is 03D2220156 - independent with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/10/2019 and was last updated on 9/27/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	171100000X	Acupuncturist		No
2	175F00000X	Naturopath		No
3	225700000X	Massage Therapist		No
4	2278G1100X	Respiratory Therapist, Certified	General Care	No
5	133NN1002X	Nutritionist	Nutrition, Education	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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