Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1073149985 |
---|---|
Provider Name | Ann Bettina Lopez-Lam |
First Address | Red Bank, NJ 07701-5670 |
Second Address | Red Bank, NJ 07701-5670 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2020 |
Last Update Date | 24/03/2020 |