Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 4401 | OK |
NPI | 1053984930 |
---|---|
Provider Name | Natalie Nichole Haworth |
First Address | Weatherford, OK 73096-5803 |
Second Address | Clinton, OK 73601-7521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2021 |
Last Update Date | 20/07/2021 |