Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L95087 |
NPI | 1053833525 |
---|---|
Provider Name | Jessica C Halley |
First Address | Oklahoma City, OK 73116-3407 |
Second Address | Oklahoma City, OK 73116-3407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2017 |
Last Update Date | 17/03/2018 |