Individual
JACLYN HAAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
801 BROADWAY N, ROUTING #0110, FARGO, ND 58102-3641
(701) 234-6294
Mailing address
801 BROADWAY N, ROUTING #0110, FARGO, ND 58102-3641
(701) 234-6294
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
R31313
ND
Other
Enumeration date
12/07/2016
Last updated
12/07/2016
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