Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-129168 | NJ |
NPI | 1386142933 |
---|---|
Provider Name | Samantha Ann Keegan |
First Address | Howell, NJ 07731-2235 |
Second Address | Howell, NJ 07731-2235 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2018 |
Last Update Date | 30/01/2018 |