Individual
LYNN THIEBAUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
1040 COLUSA AVE, BERKELEY, CA 94707-2516
(510) 529-5514
Mailing address
1040 COLUSA AVE, BERKELEY, CA 94707-2516
(510) 529-5514
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
502516
CA
Other
Enumeration date
02/07/2012
Last updated
02/07/2012
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