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Individual
SHELLY ANNE WITHERS
Active
Individual
SHELLY ANNE WITHERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, RDH, MS
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
H5578
OR
124Q00000X
Dental Hygienist
Primary
RDH 19010
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RDH 19010
STATE LICENSE
CA
Enumeration date
10/21/2008
Last updated
10/15/2014
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