Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1043725005 |
---|---|
Provider Name | Susan Marron |
First Address | Exton, PA 19341-1781 |
Second Address | Exton, PA 19341-1781 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2017 |
Last Update Date | 28/08/2018 |