Individual
CORINNE MARIE CUSTODIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 STADIUM AVE, MILL VALLEY, CA 94941-3506
(415) 535-4242
Mailing address
115 STADIUM AVE, MILL VALLEY, CA 94941-3506
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
841695
CA
Other
Enumeration date
02/05/2019
Last updated
02/05/2019
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