Individual
IMANI SADE MALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
1020 19TH ST NW STE 150, WASHINGTON, DC 20036-6103
(202) 293-5182
Mailing address
10945 PRICE MANOR WAY, LAUREL, MD 20723-6036
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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