Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-131868 |
NPI | 1093221582 |
---|---|
Provider Name | Mrs. Regina Nicole Woodley |
First Address | Athens, AL 35614-6028 |
Second Address | Athens, AL 35614-6028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2017 |
Last Update Date | 19/12/2017 |