Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 317438 | NY |
NPI | 1154972446 |
---|---|
Provider Name | Danielle M Wiebel |
First Address | Plattsburgh, NY 12901-3668 |
Second Address | Plattsburgh, NY 12901-3668 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2019 |
Last Update Date | 27/09/2019 |