Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1306283296 |
---|---|
Provider Name | Jennifer Tow |
First Address | Glastonbury, CT 06033 |
Second Address | Amston, CT 06231-1314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2013 |
Last Update Date | 31/05/2013 |