Sandra Ballard, IBCLC
Individual provider Active NPI Lactation Consultant (Non-RN) · North Logan, UT
NPI 1720701741 · NPPES record last updated Sep 23, 2022
Key facts
- NPI
- 1720701741
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Lactation Consultant (Non-RN) 174N00000X
- License
- L-17810 (UT)
- Practice address
- 2245 North 400 East
Suite 202
North Logan, UT 84341 - Phone
- (435) 554-1208
- NPI assigned
- Sep 23, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L-17810 | UT | MD | Lactation Consultant (Non-RN) |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | L-17810 | UT | Yes |
Addresses
Primary practice location
2245 North 400 East
Suite 202
North Logan, UT 84341
Mailing address
2245 N 400 E Ste 204
North Logan, UT 84341-1785
Phone (435) 554-1208
Other providers in North Logan, UT
- Aspire Therapy, LLC
- Assisting Hands Utah, LLC
- Ryan Mackay Austin
- John Charles Bailey
- Michelle C Bailey
- Deena Balls
- Jeffrey Call Baugh
- Bear Lake Community Health Center, Inc.
- Jeffrey Green Bennion
- Caitlin Sayard Benvenuti
All providers in North Logan, UT · Lactation Consultant (Non-RN) in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.