Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-165463 |
NPI | 1073149084 |
---|---|
Provider Name | Tina Marie Paschen |
First Address | Los Angeles, CA 90024-5508 |
Second Address | Los Angeles, CA 90024-5508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2020 |
Last Update Date | 21/03/2020 |