Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | ALPP-35701 | CO |
NPI | 1023324423 |
---|---|
Provider Name | Jessica Mast |
First Address | Aurora, CO 80017-4373 |
Second Address | Aurora, CO 80017-4373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2010 |
Last Update Date | 01/04/2013 |