Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1356859664 |
---|---|
Provider Name | Elizabeth Engle Corcory |
First Address | Audubon, NJ 08106-1060 |
Second Address | Audubon, NJ 08106-1060 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2018 |
Last Update Date | 21/01/2018 |