Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1134433709 |
---|---|
Provider Name | Shelly Anne Taft |
First Address | Attleboro, MA 02703-3908 |
Second Address | Attleboro, MA 02703-3908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2010 |
Last Update Date | 30/10/2014 |