Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 44663 | IN |
NPI | 1124434808 |
---|---|
Provider Name | Mrs. Aimbriel Lasley |
First Address | Indianapolis, IN 46260-5704 |
Second Address | Indianapolis, IN 46260-5704 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2014 |
Last Update Date | 02/07/2014 |