Individual
ANEESA MALOUF BEUTLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N., IBCLC
Contact information
Practice address
74 S HIGHWAY 36, WESTON, ID 83286-5000
(435) 554-1098
Mailing address
74 S HIGHWAY 36, WESTON, ID 83286-5000
(435) 554-1098
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
L-86712
ID
174N00000X
Lactation Consultant (Non-RN)
Primary
L-86712
ID
Other
Enumeration date
12/15/2015
Last updated
12/15/2015
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