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General NPI Number Information
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NPI Number | 1790519114
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Entity Type | Individual
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Provider Name | CAROLE FELICIA LEE OT; IBCLC
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Gender | Female
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Dates
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Enumeration Date | 08/28/2024
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 3309 WOOD TER
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City | LOS ANGELES
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State | CA
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Zip | 90027-2204
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Country | US
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Telephone | 323-528-1406
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Fax |
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Provider Business Mailing Address
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Address Line | 3309 WOOD TER
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City | LOS ANGELES
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State | CA
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Zip | 90027-2204
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Country | US
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Telephone | 323-528-1406
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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-152875
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapist
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License Number | 5627
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License Number State | CA
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