Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1326514225 |
---|---|
Provider Name | Mrs. Stephanie Ilene Minnich |
First Address | Brooklyn, NY 11210-3033 |
Second Address | Brooklyn, NY 11210-3033 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2018 |
Last Update Date | 17/10/2018 |