Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1134691694 |
---|---|
Provider Name | Aleesha Burke |
First Address | Glenside, PA 19038-1809 |
Second Address | Glenside, PA 19038-1809 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2018 |
Last Update Date | 21/12/2018 |