Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1184393340 |
---|---|
Provider Name | Emily Martin |
First Address | Granger, IN 46530-7744 |
Second Address | Granger, IN 46530-7744 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2021 |
Last Update Date | 10/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
L-303491 | INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS (01) | IN |