Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 280596 | MA |
NPI | 1245741891 |
---|---|
Provider Name | Rachel Sultzer |
First Address | Jacksonville, FL 32205-5807 |
Second Address | Jacksonville, FL 32205-5807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2017 |
Last Update Date | 22/10/2017 |