| NPI | 1801225503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIETRA RA'CHEL DALTON CEO 336-392-5384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WL0100X Registered Nurse, Lactation Consultant (Licence: NC L-47283) |
| Additional Taxonomies | 261Q00000X (Licence: NC L-47283) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2013-11-04 |