Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-20826 | FL |
NPI | 1033540877 |
---|---|
Provider Name | Christine Bodin |
First Address | Jacksonville, FL 32210-8323 |
Second Address | Jacksonville, FL 32210-8323 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2013 |
Last Update Date | 04/12/2013 |