Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-32042 | IL |
NPI | 1376934968 |
---|---|
Provider Name | Cynthia Siever |
First Address | Galesburg, IL 61401-4855 |
Second Address | Galesburg, IL 61401-4855 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2015 |
Last Update Date | 18/02/2015 |