Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | L-302209 | PA |
NPI | 1376001099 |
---|---|
Provider Name | Dominique Noel Pacitti |
First Address | Gwynedd Valley, PA 19437-0353 |
Second Address | Gwynedd Valley, PA 19437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2019 |
Last Update Date | 22/01/2021 |