Individual
LESLIE D AXELROD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, IBCLC
Contact information
Practice address
8706 VENTURA LN, ANNANDALE, VA 22003-4239
(703) 323-6171
Mailing address
8706 VENTURA LN, ANNANDALE, VA 22003-4239
(703) 323-6171
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
10421166
VA
Other
Enumeration date
01/01/2012
Last updated
01/01/2012
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