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Individual

MRS. KNAWONNA HALEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RDH

Contact information

Practice address
27631 DECKER PRAIRIE RD, PINEHURST, TX 77362-4157
(281) 356-3351
Mailing address
16407 TRACY CT, CONROE, TX 77306-5990
(979) 864-9102

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
17990
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
124Q0000X
INSURANCE
TX
Enumeration date
02/13/2015
Last updated
02/13/2015
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