Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | L-147666 |
NPI | 1124560677 |
---|---|
Provider Name | Lauren Frey |
First Address | Las Vegas, NV 89135-1243 |
Second Address | Las Vegas, NV 89135-1243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2016 |
Last Update Date | 29/01/2019 |