Individual
LACI ANN TANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
5221 CONCORDIA ST, FAIRFAX, VA 22032-3409
(661) 202-7545
Mailing address
5221 CONCORDIA ST, FAIRFAX, VA 22032-3409
(661) 202-7545
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-146175
—
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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