Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-18369 | IN |
NPI | 1346647229 |
---|---|
Provider Name | Donnalynn Dennis |
First Address | Jeffersonville, IN 47130-2930 |
Second Address | Jeffersonville, IN 47130-2930 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2014 |
Last Update Date | 20/11/2014 |