Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-120569 | NC |
NPI | 1265962104 |
---|---|
Provider Name | Ms. Emily Primeaux |
First Address | Fayetteville, NC 28303-2112 |
Second Address | Fayetteville, NC 28303-2112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2017 |
Last Update Date | 07/08/2017 |