Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1033628359 |
---|---|
Provider Name | Tiffany Chance |
First Address | Huntington Beach, CA 92648-6068 |
Second Address | Huntington Beach, CA 92648-6068 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2017 |
Last Update Date | 29/09/2017 |