Individual
ALEXANDRA ELIZABETH BRAVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
1509 W GAMBRELL ST, FORT WORTH, TX 76115-2206
(682) 802-9764
Mailing address
1509 W GAMBRELL ST, FORT WORTH, TX 76115-2206
(682) 802-9764
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-315102
TX
Other
Enumeration date
07/17/2024
Last updated
07/17/2024
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