Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1083943120 |
---|---|
Provider Name | Leah Goldberg-Davis |
First Address | Chicopee, MA 01013-2937 |
Second Address | Chicopee, MA 01013-2937 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2009 |
Last Update Date | 21/12/2009 |