Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 26NO11478200 | NJ |
NPI | 1134541055 |
---|---|
Provider Name | Heather Uccello |
First Address | Montville, NJ 07045-9639 |
Second Address | Montville, NJ 07045-9639 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2014 |
Last Update Date | 11/01/2014 |