Provider Demographics
NPI:1992159883
Name:SANDS, CATHERINE KENDALL (IBCLC)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:KENDALL
Last Name:SANDS
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 1:1801 N BAYLEN ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32501-2118
Mailing Address - Country:US
Mailing Address - Phone:850-454-8585
Mailing Address - Fax:
Practice Address - Street 1:1801 N BAYLEN ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32501-2118
Practice Address - Country:US
Practice Address - Phone:850-454-8585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-18
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL-17215174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN