Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-164351 |
NPI | 1003447632 |
---|---|
Provider Name | Jessica Semar |
First Address | Austin, TX 78749-3626 |
Second Address | Austin, TX 78745-2281 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2020 |
Last Update Date | 02/02/2020 |