Provider Demographics
NPI:1376309047
Name:ROJAS, FABIOLA (IBCLC)
Entity Type:Individual
Prefix:
First Name:FABIOLA
Middle Name:
Last Name:ROJAS
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:FABIOLA
Other - Middle Name:
Other - Last Name:ROJAS QUANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:IBCLC
Mailing Address - Street 1:7807 JAYWICK AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-2150
Mailing Address - Country:US
Mailing Address - Phone:703-862-3416
Mailing Address - Fax:
Practice Address - Street 1:8391 OLD COURTHOUSE RD STE 300
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-3842
Practice Address - Country:US
Practice Address - Phone:703-862-3416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAL-314346174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN