Organization
HIGH COUNTRY LACTATION CARE, INC
Active
Organization
HIGH COUNTRY LACTATION CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYA RADOCCIA-KENNEN BSW, IBCLC (VICE PRESIDENT LACTATION CONSULTANT)
(928) 556-0000
Entity
Organization
Contact information
Practice address
401 W ASPEN AVE, FLAGSTAFF, AZ 86001-5305
(928) 556-0000
(928) 556-0005
Mailing address
401 W ASPEN AVE, FLAGSTAFF, AZ 86001-5305
(928) 556-0000
(928) 556-0005
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
01/14/2020
Last updated
01/14/2020
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