Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-64869 |
NPI | 1285030205 |
---|---|
Provider Name | Danielle Mullen |
First Address | Lewiston, NY 14092-1154 |
Second Address | Lewiston, NY 14092-1154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2014 |
Last Update Date | 18/11/2014 |