Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-25205 | NJ |
NPI | 1205245537 |
---|---|
Provider Name | Leslie R Kowalski |
First Address | Plainsboro, NJ 08536-1901 |
Second Address | Plainsboro, NJ 08536-1901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2014 |
Last Update Date | 08/07/2015 |