Healthcare Provider Details

I. General information

NPI: 1265371686
Provider Name (Legal Business Name): LAVENDER & LATCH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 E BASELINE RD STE E208
TEMPE AZ
85283-1388
US

IV. Provider business mailing address

315 W ELLIOT RD STE 107
TEMPE AZ
85284-1328
US

V. Phone/Fax

Practice location:
  • Phone: 602-341-5306
  • Fax:
Mailing address:
  • Phone: 623-340-5708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name: ERICA GLAZE
Title or Position: OWNER
Credential:
Phone: 623-340-5708