| NPI | 1215287388 |
|---|---|
| Former Name | JENNIFER SUE HANEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 124Q00000X Dental Hygienist (Licence: AK 2154) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: TX 13059) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2012-09-14 |