Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | L-13938 | |
Y | 174N00000X | Lactation Consultant | L-13938 | NJ |
NPI | 1043774094 |
---|---|
Provider Name | Sakeenah Dowell |
First Address | Irvington, NJ 07111-2205 |
Second Address | Irvington, NJ 07111-2205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2019 |
Last Update Date | 23/01/2019 |