Mary Nattakom
Student in an Organized Health Care Education/Training Program in Dallas, TX. Individual provider (NPI-1).
NPI number1497331128
StatusActive
Last updated in NPPESMar 23, 2021
Details
- NPI
- 1497331128
- Entity type
- Individual (NPI-1)
- Name
- Mary Nattakom
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 23, 2021
- Certification date
- Mar 23, 2021
- Last updated
- Mar 23, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
5323 Harry Hines BlvdDallas, TX 75390-7201
Phone 214-999-9999
Mailing address
5323 Harry Hines BlvdDallas, TX 75390-7201
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