Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 11031332 | PA |
NPI | 1194017483 |
---|---|
Provider Name | Ms. Sarah Marie Glenn |
First Address | Bartonsville, PA 18321-9372 |
Second Address | Bartonsville, PA 18321-9372 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2011 |
Last Update Date | 05/05/2011 |