Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 10856463 | MD |
NPI | 1346673266 |
---|---|
Provider Name | Ms. Djuana Anita Williams |
First Address | Waldorf, MD 20602 |
Second Address | Waldorf, MD 20602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2013 |
Last Update Date | 14/08/2013 |