Individual
AMANDA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
12029 BRYONY DR, AUSTIN, TX 78739-1945
(512) 484-2637
Mailing address
12029 BRYONY DR, AUSTIN, TX 78739-1945
(512) 484-2637
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-302797
—
Other
Enumeration date
03/07/2023
Last updated
03/07/2023
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