Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 1043716 | WI |
NPI | 1003322728 |
---|---|
Provider Name | Mrs. Claudia H Weiland |
First Address | Waukesha, WI 53189-6549 |
Second Address | Milwaukee, WI 53204-3533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2017 |
Last Update Date | 18/12/2017 |