Individual
MRS. PHYLLIS GOODWIN MERRILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
21522 W LIBERTY RD, PARKTON, MD 21120-9110
(410) 343-0023
Mailing address
21522 W LIBERTY RD, PARKTON, MD 21120-9110
(410) 343-0023
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190-10574
INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS (IBLCE)
—
Enumeration date
06/04/2011
Last updated
06/04/2011
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