Individual
MRS. SANDRA MARIA DAVIS HATHAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
705 E ARTESIA BLVD, LONG BEACH, CA 90805-1439
(562) 674-8500
Mailing address
1078 E 72ND ST, LONG BEACH, CA 90805-1035
(562) 674-8500
(562) 422-7888
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
11141184
CA
Other
Enumeration date
02/07/2012
Last updated
02/07/2012
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