Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1376972075 |
---|---|
Provider Name | Stephanie R Cleary |
First Address | Greenwich, CT 06830-6831 |
Second Address | Greenwich, CT 06830-6831 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2013 |
Last Update Date | 04/11/2013 |