Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-88462 | VA |
NPI | 1235683566 |
---|---|
Provider Name | Hilary Moxon |
First Address | Manassas, VA 20112-3275 |
Second Address | Manassas, VA 20112-3275 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2016 |
Last Update Date | 03/08/2016 |