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Individual

KATHLEEN JUNE BOUSU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN IBCLC

Contact information

Practice address
7909 QUINCY ST NE, SPRING LAKE PARK, MN 55432-1974
(763) 342-1752
Mailing address
7909 QUINCY ST NE, SPRING LAKE PARK, MN 55432-1974
(763) 342-1752

Taxonomy

Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
1180068
MN

Other

Enumeration date
11/06/2021
Last updated
11/06/2021
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