Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | L-56471 | NC |
NPI | 1215443338 |
---|---|
Provider Name | Rachael Anastasio Collins |
First Address | Matthews, NC 28104-1171 |
Second Address | Matthews, NC 28104-1171 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2017 |
Last Update Date | 27/12/2017 |