Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-83577 | TX |
NPI | 1083386908 |
---|---|
Provider Name | Kaitlyn Doerner |
First Address | Whitewright, TX 75491-7562 |
Second Address | Whitewright, TX 75491-7562 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2021 |
Last Update Date | 29/09/2021 |