Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-29960 |
NPI | 1174909246 |
---|---|
Provider Name | Dawn K Martin |
First Address | Austin, TX 78758-4710 |
Second Address | Austin, TX 78758-4710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2015 |
Last Update Date | 30/07/2015 |