Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1104481258 |
---|---|
Provider Name | Rachel Ethridge Garrett |
First Address | West Columbia, SC 29169-3374 |
Second Address | West Columbia, SC 29169-3374 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2019 |
Last Update Date | 03/05/2019 |