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Individual

JESSICA UNDERWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
IBCLC

Contact information

Practice address
5315 LYNDALE AVE S, MINNEAPOLIS, MN 55419-1270
(612) 223-8064
Mailing address
3134 W BDE MAKA SKA BLVD APT 210, MINNEAPOLIS, MN 55416-6004
(763) 607-1414

Taxonomy

Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-302131

Other

Enumeration date
01/06/2021
Last updated
01/06/2021
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