Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 11245898 | NJ |
NPI | 1215278833 |
---|---|
Provider Name | Annie Pott |
First Address | Trenton, NJ 08611-1727 |
Second Address | Trenton, NJ 08611-1727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2013 |
Last Update Date | 06/03/2013 |