Individual
REBECCA WAINIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2790 12 MILE RD, BERKLEY, MI 48072-1630
(248) 439-0088
Mailing address
2790 12 MILE RD, BERKLEY, MI 48072-1630
(248) 439-0088
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
2902013388
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2902013388
MI RDH LICENSE
MI
01
—
W500734594057
MI DRIVER'S LICENSE
MI
Enumeration date
09/24/2021
Last updated
09/24/2021
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