Individual
AMANDA WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN IBCLC
Contact information
Practice address
1621 LAKEVILLE DR STE 304, KINGWOOD, TX 77339-2694
(281) 305-0411
(281) 572-0627
Mailing address
1621 LAKEVILLE DR STE 304, KINGWOOD, TX 77339-2694
(281) 305-0411
(281) 572-0627
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
780850
TX
163WL0100X
Lactation Consultant (Registered Nurse)
L-305357
VA
Other
Enumeration date
01/25/2022
Last updated
01/25/2022
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