Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | FL |
NPI | 1275811242 |
---|---|
Provider Name | Ms. Amelia Fry |
First Address | Stuart, FL 34996-3602 |
Second Address | Stuart, FL 34996-3602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2011 |
Last Update Date | 06/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004024000 | (05) | FL |
14030798 | AMERICAN SPEECH AND HEARING ASSOCIATION (01) | |
L-111185 | INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS (01) |