Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-137660 | PA |
NPI | 1285106559 |
---|---|
Provider Name | Stephanie Anne Brown |
First Address | Philadelphia, PA 19144-2011 |
Second Address | Philadelphia, PA 19144-2011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/12/2018 |
Last Update Date | 26/12/2018 |