Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 11025248 | NY |
NPI | 1003189218 |
---|---|
Provider Name | Mrs. Paula Harrison Utilla |
First Address | Brooklyn, NY 11234-6603 |
Second Address | Brooklyn, NY 11234-6603 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2012 |
Last Update Date | 17/02/2012 |