Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | 3061 | PA |
NPI | 1336602374 |
---|---|
Provider Name | Terri Ann Walker |
First Address | Pipe Creek, TX 78063-6066 |
Second Address | Pipe Creek, TX 78063-6066 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2019 |
Last Update Date | 22/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3016 | IDI (01) | PA |