Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-152699 |
NPI | 1093289639 |
---|---|
Provider Name | Hannah Vaughan |
First Address | Bloomington, IN 47408-3146 |
Second Address | Bloomington, IN 47408-3146 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2019 |
Last Update Date | 16/01/2019 |