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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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