Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | ALPP-325948 | MA |
NPI | 1366054736 |
---|---|
Provider Name | Alexis Pamela Amaral |
First Address | Charlotte, NC 28209-1500 |
Second Address | Charlotte, NC 28209-1500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2020 |
Last Update Date | 18/08/2020 |