Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | ALPP-206743 |
NPI | 1336537166 |
---|---|
Provider Name | Ashley Ppool Glenn |
First Address | Brentwood, TN 37027-7970 |
Second Address | Brentwood, TN 37027-7970 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/12/2014 |
Last Update Date | 31/12/2014 |