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Individual

ANN BENNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
IBCLC

Contact information

Practice address
2113 HIGHLAND RIDGE DR, PHOENIX, MD 21131-1217
(917) 567-5260
(917) 567-5260
Mailing address
5959 LOMITA VERDE CIR, AUSTIN, TX 78749-4208

Taxonomy

Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L13482

Other

Enumeration date
10/02/2017
Last updated
10/02/2017
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