Individual
BRENDA CARROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
22005 W 56TH ST, SHAWNEE, KS 66226-7921
(913) 481-5707
Mailing address
22005 W 56TH ST, SHAWNEE, KS 66226-7921
(913) 481-5707
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
10/04/2012
Last updated
10/04/2012
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