Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1023435427 |
---|---|
Provider Name | Danielle Mason Hogan |
First Address | Trophy Club, TX 76262-5113 |
Second Address | Grapevine, TX 76051-5203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2014 |
Last Update Date | 29/07/2014 |