Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-24791 | NC |
NPI | 1205202447 |
---|---|
Provider Name | Jennifer Lynn Rizzo |
First Address | Matthews, NC 28105-3063 |
Second Address | Matthews, NC 28105-3063 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2015 |
Last Update Date | 11/08/2015 |