Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 900 | MA |
NPI | 1467532242 |
---|---|
Provider Name | Pamela Golay Latimer |
First Address | Harwich, MA 02645-2147 |
Second Address | Harwich, MA 02645-2147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 15/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010442020 | (02) | MA |
100322000 | FEDERAL WORK COMP (01) | MA |
35265 | HARVARD PILGRIM (01) | MA |
LAY35707 | BLUE CROSS (01) | MA |