| NPI | 1689059073 |
|---|---|
| Former Name | ALYSSA PHILLIPS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: MO 2015011459) |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2024-01-29 |