Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-13051 | VA |
NPI | 1124564166 |
---|---|
Provider Name | Mrs. Carolyn Ann Hose |
First Address | Lovettsville, VA 20180-0167 |
Second Address | South Riding, VA 20152-1778 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2017 |
Last Update Date | 15/01/2017 |