Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 103-20624 | CA |
NPI | 1184917031 |
---|---|
Provider Name | Kayellen Marie Lascheck |
First Address | Cathedral City, CA 92234-2557 |
Second Address | Cathedral City, CA 92234-1119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2011 |
Last Update Date | 08/07/2014 |