Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-120068 | TX |
NPI | 1295336253 |
---|---|
Provider Name | Dawnestel Fodeibou |
First Address | Houston, TX 77014-2862 |
Second Address | Houston, TX 77014-2862 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2020 |
Last Update Date | 05/11/2020 |