Individual
TERESA LYNN DILLEN MASSILLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
1530 DOLORES ST, APT 3, SAN FRANCISCO, CA 94110-4935
(415) 821-2298
Mailing address
1530 DOLORES ST, APT 3, SAN FRANCISCO, CA 94110-4935
(415) 821-2298
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
10921004
CA
Other
Enumeration date
09/25/2012
Last updated
09/25/2012
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