Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | 17067 |
NPI | 1275152712 |
---|---|
Provider Name | Kathryn Mundall Holm |
First Address | Kennewick, WA 99338-1198 |
Second Address | Kennewick, WA 99338-1198 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2020 |
Last Update Date | 14/04/2020 |