Individual
MRS. CANDYSE ANNE MATASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
5848 MENLO DR, BATON ROUGE, LA 70808-5047
(225) 341-2411
Mailing address
18201 PINE RIDGE DR, PRAIRIEVILLE, LA 70769-3473
(225) 610-9217
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-108612
LA
Other
Enumeration date
10/18/2020
Last updated
10/18/2020
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