Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | L-137272 | MD |
NPI | 1013586502 |
---|---|
Provider Name | Ms. Christina Berlett |
First Address | White Hall, MD 21161-9113 |
Second Address | White Hall, MD 21161-9113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2021 |
Last Update Date | 21/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R167672 | RN (01) | MD |