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Individual

MRS. TONJA DENISE CARPENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
IBCLC

Contact information

Practice address
1525 AUSTIN AVE, WACO, TX 76701-1711
(254) 753-1987
Mailing address
2316 GORMAN AVE, WACO, TX 76707-2862
(254) 753-1987

Taxonomy

Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-126587

Other

Enumeration date
01/13/2018
Last updated
01/13/2018
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