Individual
MRS. KADIE MARIE TANNEHILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CLC
Contact information
Practice address
2440 EXECUTIVE DR STE 100, SAINT CHARLES, MO 63303-5607
(636) 244-4994
Mailing address
21 OAK VALLEY DR, SAINT PETERS, MO 63376-3704
(314) 258-6963
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
208839
IL
Other
Enumeration date
05/24/2017
Last updated
05/24/2017
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