Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1245509611 |
---|---|
Provider Name | Mrs. Meghan Smith |
First Address | Philadelphia, PA 19145-2316 |
Second Address | Philadelphia, PA 19145-2316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2011 |
Last Update Date | 14/12/2011 |