Individual
ISMARIE RALDIRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, IBCLC
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
1697
PR
133V00000X
Registered Dietitian
1069646
—
174N00000X
Lactation Consultant (Non-RN)
L-86786
—
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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