Healthcare Provider Details

I. General information

NPI: 1932609385
Provider Name (Legal Business Name): VEGAS VALLEY LACTATION SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2018
Last Update Date: 02/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1481 W WARM SPRINGS RD STE 136
HENDERSON NV
89014-7636
US

IV. Provider business mailing address

2551 WILLIAMSBURG ST
HENDERSON NV
89052-4932
US

V. Phone/Fax

Practice location:
  • Phone: 702-483-1666
  • Fax:
Mailing address:
  • Phone: 702-483-1666
  • 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: MRS. ALURA D HIRSCH
Title or Position: OWNER/ LACTATION CONSULTANT
Credential:
Phone: 702-483-1666