Provider Demographics
NPI:1104339498
Name:CARLTON, MEGAN LYNN (IBCLC)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:LYNN
Last Name:CARLTON
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 1:5719 W CHERRY CT
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93277-8871
Mailing Address - Country:US
Mailing Address - Phone:909-518-8407
Mailing Address - Fax:
Practice Address - Street 1:5719 W CHERRY CT
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-8871
Practice Address - Country:US
Practice Address - Phone:909-518-8407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-63862174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty