Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1164795647 |
---|---|
Provider Name | Mrs. Shannon Michelle Pratten |
First Address | Skaneateles, NY 13152-9636 |
Second Address | Skaneateles, NY 13152-9636 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2012 |
Last Update Date | 05/12/2020 |