Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 020.008302 | IL |
NPI | 1043582760 |
---|---|
Provider Name | Mrs. Rhonda Lynn Hawkins |
First Address | Christopher, IL 62822-0155 |
Second Address | Sesser, IL 62884-1814 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2012 |
Last Update Date | 27/01/2012 |