Individual
TERESA M BOWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
18 WILLOW WAY, SAINT CHARLES, MO 63304-7223
(314) 603-0873
Mailing address
18 WILLOW WAY, SAINT CHARLES, MO 63304-7223
(314) 603-0873
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
11114691
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11114691
IBCLC
MO
Enumeration date
09/11/2012
Last updated
09/11/2012
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