Individual
REBECCA NOVELLA BUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
1302 LEICESTER DR, LA PLATA, MD 20646-3549
(301) 609-8579
Mailing address
1302 LEICESTER DR, LA PLATA, MD 20646-3549
(301) 609-8579
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
522051699
FEDERAL TAX IDENTIFICATIO
—
Enumeration date
05/12/2007
Last updated
05/06/2011
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