Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-17163 | CT |
NPI | 1033756077 |
---|---|
Provider Name | Sabrina Granniss |
First Address | Westbrook, CT 06498-2810 |
Second Address | Westbrook, CT 06498-2810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2019 |
Last Update Date | 10/12/2019 |