Healthcare Provider Details

I. General information

NPI: 1265356471
Provider Name (Legal Business Name): LACTATION INFANT FEEDING ENTERPRISE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35856 N MURRAY GREY DR
SAN TAN VALLEY AZ
85143-5548
US

IV. Provider business mailing address

35856 N MURRAY GREY DR
SAN TAN VALLEY AZ
85143-5548
US

V. Phone/Fax

Practice location:
  • Phone: 480-220-9322
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: CHELSEA GRIGGS
Title or Position: OWNER
Credential: MS, CCC-SLP
Phone: 480-220-9322