Doctor Name: | SANDRA WADDELL DIAL-CRUSE |
NPI Number: | 1932109147 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RMT, RFM, CLT |
License Number: | |
Business Practice Address: | 5695 Eastex Fwy Beaumont, TX - 777066923 |
Business Phone Number: | 4099249222 |
Business Fax Number: | 4099240044 |
Mailing Address: | 3475 Briar Creek Dr, BEAUMONT |
State: | TX |
Postal Code: | 777067336 |
Phone Number: | 4098921969 |
Fax Number: | 4099240044 |
NPI Enumeration Date: | 07/29/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |