Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1124449525 |
---|---|
Provider Name | Mrs. Amy M Grossi |
First Address | New Smyrna Beach, FL 32168-1916 |
Second Address | New Smyrna Beach, FL 32168-1916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2014 |
Last Update Date | 02/01/2014 |