Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 0129000094 | VA |
NPI | 1083035752 |
---|---|
Provider Name | Maya Joy Hawthorn |
First Address | Harrisonburg, VA 22801-3584 |
Second Address | Harrisonburg, VA 22801-3584 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2013 |
Last Update Date | 26/12/2013 |