Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1053844605 |
---|---|
Provider Name | Lashonta Edwards |
First Address | Houston, TX 77060-4018 |
Second Address | Houston, TX 77060-4018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2017 |
Last Update Date | 10/04/2017 |