Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-165787 |
NPI | 1356921639 |
---|---|
Provider Name | Angel Rose Sharp |
First Address | Loyalton, CA 96118-0082 |
Second Address | Loyalton, CA 96118 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2021 |
Last Update Date | 12/04/2021 |