Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-302792 |
NPI | 1326634296 |
---|---|
Provider Name | Teresa Lance |
First Address | Austin, TX 78726 |
Second Address | Austin, TX 78748-1031 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2020 |
Last Update Date | 19/12/2020 |