Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1003217704 |
---|---|
Provider Name | Meghan Johnston |
First Address | Sandy, UT 84093-2542 |
Second Address | Sandy, UT 84093-2542 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2014 |
Last Update Date | 12/09/2014 |