Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1326474073 |
---|---|
Provider Name | Krysttel Camilla Stryczek |
First Address | Mentor, OH 44061-8605 |
Second Address | Mentor, OH 44060-4626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2013 |
Last Update Date | 14/06/2019 |