Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | L-305402 | NY |
NPI | 1356913974 |
---|---|
Provider Name | Carly J Hansen |
First Address | Buffalo, NY 14209-1458 |
Second Address | Buffalo, NY 14209-1458 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2021 |
Last Update Date | 02/01/2022 |