Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-85509 | FL |
NPI | 1104341031 |
---|---|
Provider Name | Jennifer Rebecca Chendea |
First Address | Pensacola, FL 32514-6435 |
Second Address | Pensacola, FL 32514-7796 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2017 |
Last Update Date | 11/08/2017 |