Eileen Kim Petrocelli, IBCLC
Lactation Consultant, Non-RN in Prescott Valley, AZ. Individual provider (NPI-1).
NPI number1295087203
StatusActive
Last updated in NPPESOct 15, 2012
Details
- NPI
- 1295087203
- Entity type
- Individual (NPI-1)
- Name
- Eileen Kim Petrocelli
- Credential
- IBCLC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 15, 2012
- Last updated
- Oct 15, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174N00000X | Lactation Consultant, Non-RN | 11132727 | AZ | Yes |
Other names
- Eileen Macmullen (Former Name)
Practice location
3212 N Windsong Dr2nd Floor
Prescott Valley, AZ 86314-2255
Phone 928-583-1037 · Fax 928-771-3379
Mailing address
1090 Commerce DrPrescott, AZ 86305-3700
Phone 928-771-3121 · Fax 928-771-3369
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