Individual
CASSANDRA NATASHA MACKIEWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
10190 W CANTERBURY DR, BOISE, ID 83704-5318
(951) 552-0010
Mailing address
10190 W CANTERBURY DR, BOISE, ID 83704-5318
(951) 552-0010
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-106475
ID
Other
Enumeration date
03/20/2021
Last updated
03/20/2021
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