Individual
MARY MARINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
20 ALLEN ST, MARTINEZ, CA 94553-2681
(925) 313-6098
(925) 313-6599
Mailing address
595 CENTER AVE STE 300, MARTINEZ, CA 94553-4634
(925) 313-6098
(925) 313-6599
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
10218424
CA
Other
Enumeration date
11/12/2014
Last updated
11/12/2014
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