Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1316224744 |
---|---|
Provider Name | Sarah Devane |
First Address | Oklahoma City, OK 73118-1044 |
Second Address | Oklahoma City, OK 73118-1044 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2011 |
Last Update Date | 14/11/2011 |