Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-152482 |
NPI | 1225594666 |
---|---|
Provider Name | Mrs. Sara Danielle Huddleston |
First Address | Old Hickory, TN 37138-2935 |
Second Address | Old Hickory, TN 37138-2935 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2019 |
Last Update Date | 11/02/2019 |