Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 212101-3102 | UT |
NPI | 1073942314 |
---|---|
Provider Name | Karla L Standage |
First Address | American Fork, UT 84003-2096 |
Second Address | American Fork, UT 84003-2096 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2013 |
Last Update Date | 07/11/2013 |