Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | PHDH000248 | PA |
N | 124Q00000X | Dental Hygienist | DH069520 | PA |
NPI | 1013504083 |
---|---|
Provider Name | Sherry Lynn Raabe |
First Address | West Sunbury, PA 16061-2234 |
Second Address | West Sunbury, PA 16061-2234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/12/2020 |
Last Update Date | 08/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
124Q00000X | (05) | PA |