Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1386080273 |
---|---|
Provider Name | Tina M Lavy |
First Address | Yuba City, CA 95993-5194 |
Second Address | Yuba City, CA 95993-5194 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2013 |
Last Update Date | 17/05/2013 |