Provider Demographics
NPI:1700199312
Name:KAY, HEATHER (IBCLC)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:
Last Name:KAY
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19838 N 84TH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3964
Mailing Address - Country:US
Mailing Address - Phone:609-658-3034
Mailing Address - Fax:
Practice Address - Street 1:19838 N 84TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3964
Practice Address - Country:US
Practice Address - Phone:609-658-3034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-23
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
10218292OtherIBCLC