Individual
KRISTIE FAWKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
601 PITNEY DR APT 4, SPRING LAKE, NJ 07762-2262
(617) 640-3148
Mailing address
601 PITNEY DR APT 4, SPRING LAKE, NJ 07762-2262
(617) 640-3148
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
11134129
MA
Other
Enumeration date
08/25/2014
Last updated
08/25/2014
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