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Individual

DR. CASSAUNDRA RENEA JAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD, LM, CPM, IBCLC

Contact information

Practice address
176 PINON TRL, CEDAR CREST, NM 87008-9457
(505) 407-4378
Mailing address
7708 LAZY LN, AUSTIN, TX 78757-1414
(808) 283-5373

Taxonomy

Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
11065708
NM
176B00000X
Midwife
10076R
NM
367A00000X
Advanced Practice Midwife
Primary
374J00000X
Doula

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31781349
NM
Enumeration date
10/18/2010
Last updated
04/16/2025
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