Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-94774 | TX |
NPI | 1013554823 |
---|---|
Provider Name | Katja Priester |
First Address | Austin, TX 78745-2278 |
Second Address | Round Rock, TX 78665-8000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2019 |
Last Update Date | 01/12/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
L-94774 | (05) | TX |