Individual
AMY BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
14601 ESTATE DR, WOODBRIDGE, VA 22193-3203
(703) 405-9316
Mailing address
14601 ESTATE DR, WOODBRIDGE, VA 22193-3203
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-68538
VA
Other
Enumeration date
11/14/2014
Last updated
11/14/2014
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