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Individual

TANJA KNUTSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
IBCLC

Contact information

Practice address
2121 SEA EAGLE VW, AUSTIN, TX 78738-5382
(512) 720-9688
Mailing address
2121 SEA EAGLE VW, AUSTIN, TX 78738-5382
(512) 720-9688

Taxonomy

Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-28104
ZZ

Other

Enumeration date
06/03/2014
Last updated
06/03/2014
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