Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1033736889 |
---|---|
Provider Name | Danice Miranda |
First Address | Paramus, NJ 07652-2145 |
Second Address | Paramus, NJ 07652-2145 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2020 |
Last Update Date | 09/08/2021 |