Provider Demographics
NPI:1730365206
Name:KASDORF, CHERYL A (NMD)
Entity type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:A
Last Name:KASDORF
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 1:1770 E VILLA DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:COTTONWOOD
Mailing Address - State:AZ
Mailing Address - Zip Code:86326-4647
Mailing Address - Country:US
Mailing Address - Phone:928-649-9234
Mailing Address - Fax:928-649-9334
Practice Address - Street 1:1770 E VILLA DR
Practice Address - Street 2:STE 2
Practice Address - City:COTTONWOOD
Practice Address - State:AZ
Practice Address - Zip Code:86326-4647
Practice Address - Country:US
Practice Address - Phone:928-649-9234
Practice Address - Fax:928-649-9334
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-15
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ98-544175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath