Individual
BETHANY GRACE RUIZ SALGUERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
163 DIVINITY ST, BRISTOL, CT 06010-6011
(860) 845-7507
Mailing address
163 DIVINITY ST, BRISTOL, CT 06010-6011
(860) 845-7507
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-129167
CT
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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