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1407503717
STEPHANIE ANN BODAK NICHOLSON
MOODY, TX
NPI
1407503717
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
174N00000X Lactation Consultant, Non-RN
(Licence: TX L-301558)
Enumeration Date
2022-03-07
Last Update Date
2022-03-07
Business Address
STEPHANIE ANN BODAK NICHOLSON IBCLC
15047 DOVE RD
MOODY, TX 76557-3160
Phone number: 254-913-6939
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Mailing Address
STEPHANIE ANN BODAK NICHOLSON IBCLC
15047 DOVE RD
MOODY, TX 76557-3160
Phone number: 254-913-6939
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