Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 200975 | MA |
NPI | 1356736375 |
---|---|
Provider Name | Ms. Heather Peet |
First Address | Apo, AP 96204-3026 |
Second Address | Apo, AP 96204-3026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2015 |
Last Update Date | 06/04/2015 |