Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1306382874 |
---|---|
Provider Name | Mrs. Amanda Cullen |
First Address | Clayton, DE 19938-9715 |
Second Address | Clayton, DE 19938-9715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2017 |
Last Update Date | 09/01/2017 |