Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1144853896 |
---|---|
Provider Name | Kathleen Terese Butler |
First Address | Upper Marlboro, MD 20772-4305 |
Second Address | Upper Marlboro, MD 20772-4305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2020 |
Last Update Date | 20/02/2020 |