Individual
JACQUANA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPH, IBCLC
Contact information
Practice address
723 E 34TH ST, BALTIMORE, MD 21218-2939
(984) 484-4012
Mailing address
723 E 34TH ST, BALTIMORE, MD 21218-2939
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-139768
VA
Other
Enumeration date
11/13/2023
Last updated
07/11/2024
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