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Individual

MARY WELLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
IBCLC

Contact information

Practice address
682 FISKE RD, BARTON, VT 05822-9395
(802) 355-0706
Mailing address
682 FISKE RD, BARTON, VT 05822-9395
(802) 355-0706

Taxonomy

Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
026.0017291
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
L-85063
INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS
Enumeration date
10/26/2016
Last updated
10/26/2016
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