=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306686019
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MONA WAHEEDLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/30/2024
-----------------------------------------------------
Last Update Date | 05/30/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7038 N VIA DE LA CAMPANA
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85258-3903
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-232-5536
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7038 N VIA DE LA CAMPANA
-----------------------------------------------------
City | SCOTTSDALE
-----------------------------------------------------
State | AZ
-----------------------------------------------------
Zip | 85258-3903
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 702-232-5536
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LACTATION CONSULTANT
-----------------------------------------------------
Name | MONA WAHEED
-----------------------------------------------------
Credential | IBCLC, RTR
-----------------------------------------------------
Telephone | 702-232-5536
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------