Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1275106684 |
---|---|
Provider Name | Mrs. Caitlin Ahern |
First Address | Meridian, ID 83646-6775 |
Second Address | Boise, ID 83704-8297 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2021 |
Last Update Date | 22/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
L-172184 | INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS (01) |