Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-55964 | AZ |
NPI | 1336546274 |
---|---|
Provider Name | Michaela Zach |
First Address | Chandler, AZ 85286-5629 |
Second Address | Chandler, AZ 85286-5629 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2014 |
Last Update Date | 20/11/2014 |