Individual
MARY OLIVER HUMKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
155 N GALT AVE, LOUISVILLE, KY 40206
(502) 541-5158
Mailing address
155 N GALT AVE, LOUISVILLE, KY 40206-2309
(502) 541-5158
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
KY
Other
Enumeration date
06/07/2017
Last updated
06/07/2017
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