Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | ALPP-310480 | NY |
NPI | 1205475027 |
---|---|
Provider Name | Jenny Staebell |
First Address | Oakfield, NY 14125-1232 |
Second Address | Oakfield, NY 14125-1232 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2019 |
Last Update Date | 22/01/2020 |