Individual
HAVY NGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1430 MELISSA LN, MONTGOMERY, AL 36117-8938
(334) 590-1125
Mailing address
1430 MELISSA LN, MONTGOMERY, AL 36117-8938
(334) 590-1125
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
S10791
AL
Other
Enumeration date
04/01/2015
Last updated
04/01/2015
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