Organization
HOLISTIC LACTATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE KINCER IBCLC, RLC (OWNER)
(602) 842-2863
Entity
Organization
Contact information
Practice address
4717 N 33RD PL, PHOENIX, AZ 85018-3316
(602) 842-2863
Mailing address
4717 N 33RD PL, PHOENIX, AZ 85018-3316
(602) 842-2863
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-96282
AZ
Other
Enumeration date
08/02/2016
Last updated
08/02/2016
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