Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | ALPP-23829 | MA |
NPI | 1306174057 |
---|---|
Provider Name | Mrs. Nina Leicht Crist |
First Address | Cameron, NC 28326 |
Second Address | Cameron, NC 28326 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2009 |
Last Update Date | 14/11/2016 |