Provider Demographics
NPI:1902623309
Name:CHOW, KATHRINA TEODORO (RN, IBCLC)
Entity type:Individual
Prefix:MRS
First Name:KATHRINA
Middle Name:TEODORO
Last Name:CHOW
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4926 E PRESIDIO RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-3526
Mailing Address - Country:US
Mailing Address - Phone:206-788-6903
Mailing Address - Fax:
Practice Address - Street 1:13802 N SCOTTSDALE RD STE 163
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-3437
Practice Address - Country:US
Practice Address - Phone:480-999-1585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ290140163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant