Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 25573 | MA |
NPI | 1154662963 |
---|---|
Provider Name | Portia J Gadson |
First Address | Cleveland, OH 44128-1951 |
Second Address | Cleveland, OH 44128-1951 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2013 |
Last Update Date | 05/03/2013 |