Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1316522428 |
---|---|
Provider Name | Jessica Espinoza Simpson |
First Address | Fairfax, VA 22030-7273 |
Second Address | Fairfax, VA 22030-7273 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2021 |
Last Update Date | 10/03/2021 |