Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | ALPP-310006 | NY |
NPI | 1265999452 |
---|---|
Provider Name | Lakeisha Grenade-Shoemaker |
First Address | East Aurora, NY 14052-9778 |
Second Address | East Aurora, NY 14052-9778 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/02/2019 |
Last Update Date | 25/02/2019 |