Individual
MELANIE HENSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
6689 E PLAYWRIGHT DR, BOISE, ID 83716-5831
(971) 235-8773
Mailing address
6689 E PLAYWRIGHT DR, BOISE, ID 83716-5831
(971) 235-8773
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-126472
ID
Other
Enumeration date
07/30/2018
Last updated
07/30/2018
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