Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | LNO 2105 | TN |
NPI | 1013938851 |
---|---|
Provider Name | Mary Lou Yarrington |
First Address | Chattanooga, TN 37421 |
Second Address | Chattanooga, TN 37411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 08/07/2007 |