Individual
TESSA KACZOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4658 13TH ST, BOULDER, CO 80304-0889
(720) 537-9286
Mailing address
4658 13TH ST, BOULDER, CO 80304-0889
(720) 537-9286
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
01/02/2016
Last updated
01/02/2016
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