Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-300797 | TX |
NPI | 1316526429 |
---|---|
Provider Name | Shallon Michelle May-Rogers |
First Address | Georgetown, TX 78628-7076 |
Second Address | Georgetown, TX 78628-7076 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2021 |
Last Update Date | 06/04/2021 |