Individual
TRINE BRADSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
9709 E IMPALA AVE, MESA, AZ 85209-7044
(480) 242-5588
Mailing address
9709 E IMPALA AVE, MESA, AZ 85209-7044
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-17897
AZ
Other
Enumeration date
01/11/2016
Last updated
01/11/2016
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