Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-22310 | MO |
NPI | 1316488554 |
---|---|
Provider Name | Mrs. Jodee Lamp |
First Address | Imperial, MO 63052-4030 |
Second Address | Imperial, MO 63052-4030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2017 |
Last Update Date | 20/03/2017 |