Individual
STEPHANIE INGRAM RACZKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, PHN, IBCLC
Contact information
Practice address
4536 HIGHWAY 49 S, MARIPOSA, CA 95338-9326
(215) 301-5827
Mailing address
4536 HIGHWAY 49 S, MARIPOSA, CA 95338-9326
(215) 301-5827
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
802712
CA
Other
Enumeration date
06/26/2018
Last updated
06/26/2018
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