Individual
MRS. TANYA POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA, CLE, IBCLC
Contact information
Practice address
4460 REDWOOD HWY STE 16-379, SAN RAFAEL, CA 94903-1951
(415) 302-4354
Mailing address
4460 REDWOOD HWY STE 16-379, SAN RAFAEL, CA 94903-1951
(415) 302-4354
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
IBCLC #L-57367
—
Other
Enumeration date
10/28/2014
Last updated
10/28/2014
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