Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 11145322 | PA |
NPI | 1013374230 |
---|---|
Provider Name | Mrs. Cynthia Lafferty |
First Address | Queen Creek, AZ 85142-6524 |
Second Address | Queen Creek, AZ 85142-6524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2016 |
Last Update Date | 19/01/2016 |