Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist |
NPI | 1043669252 |
---|---|
Provider Name | Mrs. Jennifer Warren Treat |
First Address | Fort Hood, TX 76544-5042 |
Second Address | Fort Hood, TX 76544-5042 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2016 |
Last Update Date | 08/06/2016 |