Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 302097 | PA |
NPI | 1255925228 |
---|---|
Provider Name | Miladis Presbery |
First Address | Philadelphia, PA 19149-1624 |
Second Address | Philadelphia, PA 19149-1624 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2021 |
Last Update Date | 21/02/2021 |