Provider Demographics
NPI:1710147095
Name:LAVOIRE, DANI JOELLE ATLAS (LM, CPM, IBCLC)
Entity Type:Individual
Prefix:
First Name:DANI
Middle Name:JOELLE ATLAS
Last Name:LAVOIRE
Suffix:
Gender:F
Credentials:LM, CPM, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1853 ROCKY RD
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86305-1332
Mailing Address - Country:US
Mailing Address - Phone:928-308-9656
Mailing Address - Fax:928-441-1980
Practice Address - Street 1:407 E SHELDON ST
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-3119
Practice Address - Country:US
Practice Address - Phone:928-308-9656
Practice Address - Fax:928-441-1980
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-11
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLM0156176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife