Individual
KATHERINE HAVENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
7922 SEQUOIA DR, ROANOKE, VA 24019-1847
(540) 926-4111
Mailing address
7922 SEQUOIA DR, ROANOKE, VA 24019-1847
(540) 926-4111
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-99575
VA
Other
Enumeration date
11/05/2016
Last updated
03/05/2020
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