Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1033792106 |
---|---|
Provider Name | Snanobia Pack |
First Address | Brooklyn, NY 11213-2906 |
Second Address | Brooklyn, NY 11213-2906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2021 |
Last Update Date | 05/05/2021 |