Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 903667 | CO |
NPI | 1073789194 |
---|---|
Provider Name | Paula S Barclay |
First Address | Edwards, CO 81632-8109 |
Second Address | Edwards, CO 81632-8109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2008 |
Last Update Date | 08/05/2008 |