Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1245503747 |
---|---|
Provider Name | Ms. Laura Mccormick |
First Address | Shelburne, VT 05482-6789 |
Second Address | Shelburne, VT 05482-6789 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2012 |
Last Update Date | 14/02/2012 |