Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 008377 | CT |
NPI | 1043761794 |
---|---|
Provider Name | Stephanie Howells |
First Address | Middletown, CT 06457-2718 |
Second Address | New London, CT 06320-4902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2016 |
Last Update Date | 18/10/2016 |