Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-127107 | PA |
NPI | 1073086971 |
---|---|
Provider Name | Devon Miller |
First Address | Lancaster, PA 17603-4618 |
Second Address | Lancaster, PA 17603-4618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2019 |
Last Update Date | 03/01/2019 |