Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-17105 | NY |
NPI | 1013415645 |
---|---|
Provider Name | Linda S Grace |
First Address | Niagara Falls, NY 14304-2923 |
Second Address | North Tonawanda, NY 14120-1114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2018 |
Last Update Date | 29/01/2018 |