Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-41619 | NY |
NPI | 1245875392 |
---|---|
Provider Name | Rachel Leibson |
First Address | Bronx, NY 10471-2505 |
Second Address | Bronx, NY 10471-2505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2019 |
Last Update Date | 13/11/2019 |