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NPI 1073987624

NPI 1073987624 : HALINA VAUGHAN BS-MCH, IBCLC : HASTINGS, MI

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General NPI Number Information
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    NPI Number           |    1073987624
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    Entity Type          |    Individual 
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    Provider Name        |    HALINA VAUGHAN BS-MCH, IBCLC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/19/2015
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    Last Update Date     |    09/22/2016
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Provider Practice Location Address
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    Address Line         |    1302 WELCOME RD 
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    City                 |    HASTINGS
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    State                |    MI
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    Zip                  |    49058-9423
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    Country              |    US
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    Telephone            |    650-690-4862
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1302 WELCOME RD 
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    City                 |    HASTINGS
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    State                |    MI
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    Zip                  |    49058-9423
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    Country              |    US
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    Telephone            |    650-690-4862
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    174N00000X
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    Taxonomy Name        |    Lactation Consultant (Non-RN)
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    License Number       |    L-82263
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    License Number State |    
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