Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1235809112 |
---|---|
Provider Name | Mrs. Jennifer Lauren Breuninger |
First Address | South Orange, NJ 07079-2460 |
Second Address | South Orange, NJ 07079-2460 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2021 |
Last Update Date | 14/09/2021 |