| NPI | 1346905007 |
|---|---|
| Former Name | JESSICA DANIELLE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174N00000X Lactation Consultant, Non-RN (Licence: L-307238) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MA 327448) |
| Enumeration Date | 2021-11-07 |
| Last Update Date | 2024-01-28 |