Mariah Dawn Wilson, ND
Individual provider Active NPI Naturopath · Traverse City, MI
NPI 1760958599 · NPPES record last updated Oct 19, 2018
Key facts
- NPI
- 1760958599
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Naturopath 175F00000X
- License
- 099.0134060 (VT)
- Practice address
- 3180 Racquet Club Dr Ste B
Traverse City, MI 49684-4797 - Phone
- (231) 252-9000
- NPI assigned
- Oct 19, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 099.0134060 | VT | MD | Naturopath |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | 099.0134060 | VT | Yes |
Addresses
Primary practice location
3180 Racquet Club Dr Ste B
Traverse City, MI 49684-4797
Mailing address
3180 Racquet Club Dr Ste B
Traverse City, MI 49684-4797
Phone (231) 252-9000
Other providers in Traverse City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.