Provider Demographics
NPI:1093411217
Name:WOMBAN EVOLVED
Entity Type:Organization
Organization Name:WOMBAN EVOLVED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/LACTATION CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:APHRICA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARROW
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:512-981-8019
Mailing Address - Street 1:1725 WOODLANDS DR
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-2607
Mailing Address - Country:US
Mailing Address - Phone:512-981-8019
Mailing Address - Fax:
Practice Address - Street 1:1725 WOODLANDS DR
Practice Address - Street 2:
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-2607
Practice Address - Country:US
Practice Address - Phone:512-775-0939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty