Individual
MRS. TAWANDA LOGAN-HURT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
114 WARE ST, SIDON, MS 38954-6648
(662) 458-2379
Mailing address
PO BOX 194, SIDON, MS 38954-0194
(662) 458-2379
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-306983
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L-306983
INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS
—
Enumeration date
09/12/2022
Last updated
09/12/2022
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