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Individual
MISS STACEY L HENRY
Active
Individual
MISS STACEY L HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2878
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2878
RDH
NH
Enumeration date
03/16/2010
Last updated
03/16/2010
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