Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1154799393 |
---|---|
Provider Name | Lisa Broderick-Cohen |
First Address | Moorestown, NJ 08057-2303 |
Second Address | Moorestown, NJ 08057-2303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2015 |
Last Update Date | 04/09/2015 |