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General NPI Number Information
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NPI Number | 1760926224
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Entity Type | Individual
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Provider Name | PAMELA PRICE IBCLC, LPN
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Gender | Female
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Dates
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Enumeration Date | 12/16/2016
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Last Update Date | 12/16/2016
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Provider Practice Location Address
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Address Line | 4443 BORROW PIT RD
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City | HOLLYWOOD
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State | SC
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Zip | 29449-5991
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Country | US
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Telephone | 843-209-3477
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Fax |
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Provider Business Mailing Address
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Address Line | 4443 BORROW PIT RD
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City | HOLLYWOOD
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State | SC
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Zip | 29449-5991
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Country | US
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Telephone | 843-209-3477
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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 | 102-18619
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License Number State | SC
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