Individual
DOREEN SULLIVAN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
20 SPRUCE LN, GLASTONBURY, CT 06033-1668
(860) 798-4239
Mailing address
20 SPRUCE LN, GLASTONBURY, CT 06033-1668
(860) 798-4239
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-141813
—
Other
Enumeration date
09/11/2018
Last updated
09/11/2018
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