Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1356014617 |
---|---|
Provider Name | Jessica R Fox |
First Address | Crown Point, IN 46307-4840 |
Second Address | Crown Point, IN 46307-4840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2021 |
Last Update Date | 31/07/2021 |