Individual
DAWN HOUGHTALING-BRYDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
32 FOSTER RD, WHITE LAKE, NY 12786
(845) 239-9812
Mailing address
PO BOX 651, SMALLWOOD, NY 12778-0651
(845) 239-9812
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
271469-1
NY
Other
Enumeration date
06/18/2018
Last updated
06/18/2018
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