Organization
TERESA MCCORMACK LACTATION SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA ANN MCCORMACK RN, IBCLC (MANAGING MEMBER)
(858) 216-6257
Entity
Organization
Contact information
Practice address
4443 30TH ST STE 205, SAN DIEGO, CA 92116-4291
(619) 567-8146
Mailing address
9728 MARILLA DR UNIT 205, LAKESIDE, CA 92040-2853
(858) 216-6257
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
—
—
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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