Provider Demographics
NPI:1215143482
Name:BUTLER, ANITA ALYNE (BA-IBCLC, CD(DONA),)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:ALYNE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:BA-IBCLC, CD(DONA),
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 91316
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92169-3316
Mailing Address - Country:US
Mailing Address - Phone:619-636-7225
Mailing Address - Fax:
Practice Address - Street 1:9845 ERMA RD STE 200
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131
Practice Address - Country:US
Practice Address - Phone:619-636-7225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist