Provider Demographics
NPI:1760926919
Name:ARMENOFF, HEATHER (IBCLC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:ARMENOFF
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:JANELLE
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:IBCLC
Mailing Address - Street 1:3433 COVE VIEW BLVD
Mailing Address - Street 2:1209
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77554-8175
Mailing Address - Country:US
Mailing Address - Phone:832-808-1546
Mailing Address - Fax:
Practice Address - Street 1:3433 COVE VIEW BLVD
Practice Address - Street 2:1209
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77554-8175
Practice Address - Country:US
Practice Address - Phone:832-808-1546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL-34816174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXL-34816OtherIBLCE