Individual
BETHANY WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
2114 SPRING DR, HAYNESVILLE, LA 71038-5518
(318) 624-2243
Mailing address
2114 SPRING DR, HAYNESVILLE, LA 71038-5518
(318) 624-2243
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
11192214
—
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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