Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 333696 | CT |
NPI | 1255084885 |
---|---|
Provider Name | Zully Santana |
First Address | Bethel, CT 06801-8001 |
Second Address | Bethel, CT 06801-8001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2022 |
Last Update Date | 02/02/2022 |