Individual
ANTONINA PROSHAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
811 GRAND AVE STE A1, SACRAMENTO, CA 95838-3466
(916) 875-2182
Mailing address
3970 MARTIS ST, WEST SACRAMENTO, CA 95691-6205
(916) 607-3808
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-153111
CA
Other
Enumeration date
05/05/2020
Last updated
05/05/2020
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