Individual
JEANNE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CLC
Contact information
Practice address
260 SHADYSIDE RD, RAMSEY, NJ 07446-1718
(201) 638-1600
Mailing address
260 SHADYSIDE RD, RAMSEY, NJ 07446-1718
(201) 638-1600
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
61-1679498
NJ
Other
Enumeration date
12/01/2014
Last updated
12/01/2014
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