Individual
JEANETTE MCCULLOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC, RLC
Contact information
Practice address
115 1ST ST, ITHACA, NY 14850-3405
(607) 330-2741
Mailing address
115 1ST ST, ITHACA, NY 14850-3405
(607) 330-2741
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
11093528
—
Other
Enumeration date
04/09/2011
Last updated
04/09/2011
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