Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | L-68965 | CT |
NPI | 1215007919 |
---|---|
Provider Name | Mrs. Allyson Leigh Dacruz |
First Address | Canton, CT 06019-2116 |
Second Address | Farmington, CT 06030-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2006 |
Last Update Date | 16/04/2020 |