Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1124603469 |
---|---|
Provider Name | Kaila Janai Matthews |
First Address | Memphis, TN 38119-7847 |
Second Address | Memphis, TN 38119-7847 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2021 |
Last Update Date | 17/03/2021 |