Individual
SHANNON M COUILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CLC
Contact information
Practice address
4397 WYNDCLIFF CIR, ORLANDO, FL 32817-3310
(407) 243-8571
Mailing address
10151 UNIVERSITY BLVD # 241, ORLANDO, FL 32817-1904
(407) 243-8571
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
259524
DE
Other
Enumeration date
07/27/2018
Last updated
07/27/2018
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