Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 19010598 | OK |
NPI | 1205189230 |
---|---|
Provider Name | Mrs. Patricia Kay Sanders |
First Address | Elgin, OK 73538-2303 |
Second Address | Elgin, OK 73538-2303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2012 |
Last Update Date | 15/10/2012 |