Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 315178 | KY |
NPI | 1255956728 |
---|---|
Provider Name | Samantha Steen |
First Address | Bowling Green, KY 42101-2242 |
Second Address | Bowling Green, KY 42101-2242 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2020 |
Last Update Date | 10/06/2020 |