Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1245879212 |
---|---|
Provider Name | Mattea Lynn Alexander |
First Address | Carrboro, NC 27510-2067 |
Second Address | Carrboro, NC 27510-2067 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2019 |
Last Update Date | 23/12/2019 |