Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1245653856 |
---|---|
Provider Name | Mrs. Teglene A Ryan |
First Address | Arnold, CA 95223-2503 |
Second Address | Arnold, CA 95223-2503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2014 |
Last Update Date | 03/02/2014 |