Individual
MAYA RADOCCIA-KENNEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
510 MAIN ST, CLARKDALE, AZ 86324
(928) 301-3274
Mailing address
PO BOX 225, CLARKDALE, AZ 86324-0225
(928) 301-3274
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
07/31/2015
Last updated
07/31/2015
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