Individual
MELISSA MARIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
905 FORKSBRIDGE CT, GAMBRILLS, MD 21054-1655
(301) 266-0475
Mailing address
905 FORKSBRIDGE CT, GAMBRILLS, MD 21054-1655
(301) 266-0475
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
R148396
MD
Other
Enumeration date
04/03/2020
Last updated
04/03/2020
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