Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 126800000X | Dental Assistant |
NPI | 1053904441 |
---|---|
Provider Name | Rachel Haight |
First Address | Cedar Rapids, IA 52404-8619 |
Second Address | Cedar Rapids, IA 52404-8619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/02/2021 |
Last Update Date | 16/02/2021 |