Individual
LAVAWN DAUGHERTY-SOUTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN, IBCLC
Contact information
Practice address
800 W BURRELL DR, CROWN POINT, IN 46307-8898
(219) 663-9913
(219) 663-9923
Mailing address
800 W BURRELL DR, CROWN POINT, IN 46307-8898
(219) 663-9913
(219) 663-9923
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
27047986A
IN
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
11/26/2013
Last updated
12/03/2013
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