Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | TX |
NPI | 1376178855 |
---|---|
Provider Name | Courtney Jade Hamilton |
First Address | Prosper, TX 75078-8983 |
Second Address | Dallas, TX 75226-1645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2020 |
Last Update Date | 05/03/2020 |