Individual
GAIL GRESHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
111 RAMBLE LN STE 115, AUSTIN, TX 78745-2281
(512) 808-0237
Mailing address
743 CHERICO ST, AUSTIN, TX 78702-4002
(512) 799-6155
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-15654
TX
Other
Enumeration date
01/17/2020
Last updated
01/17/2020
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