Individual
JOHANNA AIDA VANDEMOORTELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
3981 BEETHOVEN ST, LOS ANGELES, CA 90066-4144
(310) 745-0177
Mailing address
3981 BEETHOVEN ST, LOS ANGELES, CA 90066-4144
(310) 745-0177
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
138466
—
Other
Enumeration date
01/03/2019
Last updated
01/03/2019
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