Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1356747281 |
---|---|
Provider Name | Jamie Lee |
First Address | Duncan, OK 73533-4710 |
Second Address | Duncan, OK 73533-4710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2014 |
Last Update Date | 04/11/2014 |