Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 19613354 |
NPI | 1104176189 |
---|---|
Provider Name | Ms. Wendy Jordan |
First Address | Exeter, NH 03833-2905 |
Second Address | Exeter, NH 03833-2905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2012 |
Last Update Date | 17/09/2012 |