Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-302621 | MA |
NPI | 1205165412 |
---|---|
Provider Name | Teresa Coyle-Airey |
First Address | Ashburnham, MA 01430-1134 |
Second Address | Townsend, MA 01469-1398 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2009 |
Last Update Date | 01/02/2022 |