Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath |
NPI | 1326315656 |
---|---|
Provider Name | Valena Mcmillion-Claiborne |
First Address | Bloomington, IL 61701-6753 |
Second Address | Bloomington, IL 61701-6753 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2011 |
Last Update Date | 01/12/2011 |