Individual
CATHRYN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4131 SPICEWOOD SPRINGS RD, SUITE C1, AUSTIN, TX 78759-8661
(512) 873-0700
(512) 340-9908
Mailing address
4131 SPICEWOOD SPRINGS RD, SUITE C1, AUSTIN, TX 78759-8661
(512) 873-0700
(512) 340-9908
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-16605
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L-16605
IBLCE
VA
Enumeration date
05/19/2014
Last updated
05/19/2014
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