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General NPI Number Information
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NPI Number | 1265254874
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Entity Type | Organization
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Legal Business Name | MILK WITH TEA
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Dates
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Enumeration Date | 10/26/2024
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Last Update Date | 10/26/2024
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Provider Practice Location Address
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Address Line | 6063 MOUNT MORIAH ROAD EXT STE 14-172
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City | MEMPHIS
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State | TN
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Zip | 38115-2757
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Country | US
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Telephone | 901-350-5270
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Fax |
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Provider Business Mailing Address
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Address Line | 6063 MOUNT MORIAH ROAD EXT STE 14-172
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City | MEMPHIS
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State | TN
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Zip | 38115-2757
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Country | US
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Telephone | 901-350-5270
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Fax |
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Authorized Official
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Title or Position | LACTATION CONSULTANT
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Name | TALITA OSEGUERA
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Credential |
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Telephone | 310-430-5964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number |
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License Number State |
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