Individual
MARY CLARE OVALLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, IBCLC
Contact information
Practice address
10290 N DEARING AVE, FRESNO, CA 93730-4772
(559) 304-0348
Mailing address
10290 N DEARING AVE, FRESNO, CA 93730-4772
(559) 304-0348
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
655589
CA
174N00000X
Lactation Consultant (Non-RN)
Primary
L-28731
CA
Other
Enumeration date
01/24/2020
Last updated
01/24/2020
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