Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-49906 | NY |
NPI | 1285164608 |
---|---|
Provider Name | Sheilah Evelyn Burnham |
First Address | East Meredith, NY 13757-1190 |
Second Address | East Meredith, NY 13757-1190 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2017 |
Last Update Date | 18/06/2017 |