Organization
LACTATION SERVICES OF WACO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONJA DENISE CARPENTER IBCLC,PCD (OWNER)
(254) 753-1987
Entity
Organization
Contact information
Practice address
1525 AUSTIN AVE, WACO, TX 76701-1711
(254) 753-1987
Mailing address
2316 GORMAN AVE, WACO, TX 76707-2862
(254) 753-1987
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-126587
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L-126587
INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS
TX
Enumeration date
01/13/2018
Last updated
01/18/2018
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