Healthcare Provider Details

I. General information

NPI: 1083496459
Provider Name (Legal Business Name): MAKING MOMMIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2023
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13951 N SCOTTSDALE RD STE 110
SCOTTSDALE AZ
85254-3454
US

IV. Provider business mailing address

4140 E PINTO LN
PHOENIX AZ
85050-8981
US

V. Phone/Fax

Practice location:
  • Phone: 626-716-6324
  • Fax:
Mailing address:
  • Phone: 626-716-6324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBIN LOMMORI
Title or Position: MEDICAL DIRECTOR
Credential: LM, CPM, IBCLC
Phone: 626-716-6324