Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L25365 | NY |
NPI | 1336562198 |
---|---|
Provider Name | Bridget Kuchta |
First Address | Tonawanda, NY 14150-7401 |
Second Address | Tonawanda, NY 14150-7401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2014 |
Last Update Date | 30/01/2014 |