Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1265842546 |
---|---|
Provider Name | Johanna Elisabeth Iwaszkowiec |
First Address | Saint Charles, MO 63301-2433 |
Second Address | O Fallon, MO 63366-2620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2014 |
Last Update Date | 12/09/2020 |