Individual
MARISA ELIZABETH POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
3790 ROUGGLY RD, VALLES MINES, MO 63087-1310
(314) 954-8689
Mailing address
3790 ROUGGLY RD, VALLES MINES, MO 63087-1310
(314) 954-8689
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
2019042223
MO
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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