Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | ALPP227787 | PA |
NPI | 1043729445 |
---|---|
Provider Name | Alyssa Mierta |
First Address | Allentown, PA 18103-3625 |
Second Address | Allentown, PA 18103-3625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2017 |
Last Update Date | 28/09/2017 |