Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | NO LICENSE |
NPI | 1235488578 |
---|---|
Provider Name | Jennifer Lynne Wowk-Ward |
First Address | Pensacola, FL 32507-1301 |
Second Address | Pensacola, FL 32507-1301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2012 |
Last Update Date | 31/08/2012 |