Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 312880 | MT |
NPI | 1134758154 |
---|---|
Provider Name | Shannon Hochhalter |
First Address | Victor, MT 59875 |
Second Address | Victor, MT 59875 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2020 |
Last Update Date | 02/04/2020 |