Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1033402763 |
---|---|
Provider Name | Cynthia O'neil |
First Address | Boise, ID 83713-1513 |
Second Address | Boise, ID 83713-1513 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2011 |
Last Update Date | 27/05/2011 |