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Individual

IMANI SADE MALLARD

Active
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Individual

IMANI SADE MALLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, IBCLC

Taxonomy

Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-319151
MD
163WN0002X
Neonatal Intensive Care Registered Nurse
R254502
MD
163WN0003X
Low-Risk Neonatal Registered Nurse
RN500016940
DC

Other

Enumeration date
08/18/2025
Last updated
08/18/2025
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