Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 102-18421 | CA |
NPI | 1336587633 |
---|---|
Provider Name | Mrs. Nancy Louise Manix |
First Address | Aliso Viejo, CA 92656-1400 |
Second Address | Aliso Viejo, CA 92656-1400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2013 |
Last Update Date | 07/06/2013 |