Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-23873 | AZ |
NPI | 1295191559 |
---|---|
Provider Name | Asa Lader |
First Address | Tucson, AZ 85716-5021 |
Second Address | Tucson, AZ 85716-5021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/01/2016 |
Last Update Date | 01/01/2016 |