Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-86688 | NY |
NPI | 1144689944 |
---|---|
Provider Name | Catherine Wightman |
First Address | Dansville, NY 14437-1623 |
Second Address | Dansville, NY 14437-1623 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2016 |
Last Update Date | 02/06/2016 |