Provider Demographics
NPI:1841663796
Name:ROSALES, KARA L (IBCLC)
Entity type:Individual
Prefix:MRS
First Name:KARA
Middle Name:L
Last Name:ROSALES
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 1:5503 CREEK VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-1896
Mailing Address - Country:US
Mailing Address - Phone:817-896-7054
Mailing Address - Fax:
Practice Address - Street 1:5503 CREEK VALLEY DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-1896
Practice Address - Country:US
Practice Address - Phone:817-896-7054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-31
Last Update Date:2015-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL-84364174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN