Individual
SUSAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
2180 S 1300 E STE 600, PARKVIEW PLAZA ONE, SALT LAKE CITY, UT 84106-4462
(801) 580-4419
Mailing address
PO BOX 522425, SALT LAKE CITY, UT 84152-2425
(801) 580-4419
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-17518
UT
Other
Enumeration date
05/21/2014
Last updated
05/21/2014
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