Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1083064489 |
---|---|
Provider Name | Rachel Martinez |
First Address | Englewood, TN 37329-5101 |
Second Address | Englewood, TN 37329-5101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2016 |
Last Update Date | 16/06/2016 |