Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | NO LICENSE |
NPI | 1104172675 |
---|---|
Provider Name | Mrs. Liane Corbin Varnes |
First Address | Cleveland, GA 30528-3001 |
Second Address | Cleveland, GA 30528-3001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2012 |
Last Update Date | 01/08/2012 |