Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | 99084 | TX |
NPI | 1003046376 |
---|---|
Provider Name | Sasha Huckaby |
First Address | Lockhart, TX 78644-4180 |
Second Address | Lockhart, TX 78644-4180 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2009 |
Last Update Date | 21/07/2009 |