Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 904434 | CO |
NPI | 1023248374 |
---|---|
Provider Name | Mrs. Andrea Lynn Pickett |
First Address | Highlands Ranch, CO 80126-7541 |
Second Address | Highlands Ranch, CO 80126-8066 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2009 |
Last Update Date | 21/07/2009 |