Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | $$$$$$$$$ | CA |
NPI | 1255085643 |
---|---|
Provider Name | Talitha Jannelle Brewer |
First Address | Fallbrook, CA 92028-3942 |
Second Address | Fallbrook, CA 92028-3942 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2022 |
Last Update Date | 05/02/2022 |