Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | L-157318 |
NPI | 1235743048 |
---|---|
Provider Name | Lauren Davidheiser |
First Address | Philadelphia, PA 19102-2737 |
Second Address | Philadelphia, PA 19102-2737 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2020 |
Last Update Date | 13/12/2021 |