Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | LC-LC-10206610 | OR |
NPI | 1235765819 |
---|---|
Provider Name | Jessica Spevak Barbosa |
First Address | Eugene, OR 97401-1109 |
Second Address | Eugene, OR 97401-1109 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2020 |
Last Update Date | 16/03/2020 |