Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1295387801 |
---|---|
Provider Name | Jennifer Lynn Gowdy |
First Address | Broomall, PA 19008-2004 |
Second Address | Broomall, PA 19008-2004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2019 |
Last Update Date | 13/07/2019 |