Healthcare Provider Details

I. General information

NPI: 1992184949
Provider Name (Legal Business Name): MILK AND HONEY, FEEDING AND SPEECH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2015
Last Update Date: 05/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3844 E PIMA ST
TUCSON AZ
85716-3308
US

IV. Provider business mailing address

3844 E PIMA ST
TUCSON AZ
85716-3308
US

V. Phone/Fax

Practice location:
  • Phone: 520-349-7745
  • Fax:
Mailing address:
  • Phone: 520-349-7745
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License NumberRN161795
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MRS. NINA ISAAC
Title or Position: SPEECH THERAPIST
Credential: SLP, CCC, IBCLC
Phone: 520-975-9495