Individual
TIFFANY H ANOMALY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
13333 PREUIT PL, HERNDON, VA 20170-4341
(276) 780-2549
Mailing address
13333 PREUIT PL, HERNDON, VA 20170-4341
(276) 780-2549
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-301011
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L-301011
IBCLC #
—
Enumeration date
02/21/2022
Last updated
03/24/2022
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