Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1295142164 |
---|---|
Provider Name | Miranda Galliani |
First Address | Newport News, VA 23602-9638 |
Second Address | Newport News, VA 23602-9638 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2014 |
Last Update Date | 12/06/2015 |