Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1073722583 |
---|---|
Provider Name | Lisa R. Mandell |
First Address | Havertown, PA 19083-1654 |
Second Address | Havertown, PA 19083-1654 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 28/04/2011 |