Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | RDH21440 | CA |
NPI | 1013574359 |
---|---|
Provider Name | Therese Jeanne Howell |
First Address | Sonora, CA 95370-6210 |
Second Address | Sonora, CA 95370-5908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2019 |
Last Update Date | 22/05/2019 |