Individual
EILEEN KIM PETROCELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
3212 N WINDSONG DR, 2ND FLOOR, PRESCOTT VALLEY, AZ 86314-2255
(928) 583-1037
(928) 771-3379
Mailing address
1090 COMMERCE DR, PRESCOTT, AZ 86305-3700
(928) 771-3121
(928) 771-3369
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
11132727
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11132727
IBCLC
AZ
Enumeration date
10/15/2012
Last updated
10/15/2012
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