Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1306421326 |
---|---|
Provider Name | Kesha Ramona King |
First Address | Brooklyn, NY 11239-2702 |
Second Address | Brooklyn, NY 11239-2702 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2021 |
Last Update Date | 11/03/2021 |