DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

PROF. BRENDA LEE ROUNDTREE, NDTR

Active Sole Proprietor

136A00000X · GILBERT, AZ

Registration Details

NPI Number
1588385132
Provider Type
Individual
Gender
Female
NPI Issued
Sep 12, 2022 (3.609204058703 yrs)
Last Updated
Sep 12, 2022
Licenses
1085276 (AZ)
1085276 (AZ)
1085276 (AZ)
Sole Proprietor
Yes

Practice Information

Address
3103 E COUNTRY SHADOWS ST
GILBERT, AZ, 852989026
Browse AZ providers · Browse ZIP 85298
Phone
6028536927
Primary Specialty
136A00000X
136A00000X
Additional Specialty
Nutrition, Education
Additional Specialty
136A00000X

Other 136A00000X Providers in GILBERT, AZ

Name Credential NPI
MS. TAMARA J DAMON 1952959108
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.