Individual
JULISSA NICHEAL THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4079 ELY AVE, BRONX, NY 10466-2207
(646) 241-0562
Mailing address
4079 ELY AVE, BRONX, NY 10466-2207
(646) 241-0562
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-305742
—
Other
Enumeration date
01/10/2024
Last updated
01/10/2024
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