Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 2902016134 | MI |
NPI | 1033530662 |
---|---|
Provider Name | Andrea Hanel |
First Address | Flint, MI 48502-1641 |
Second Address | Flint, MI 48505-4452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2013 |
Last Update Date | 28/12/2013 |