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1629513940
KELLY SORENSEN
ATHOL, ID
NPI
1629513940
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
174N00000X Lactation Consultant, Non-RN
(Licence: ID L-110382)
Enumeration Date
2016-12-21
Last Update Date
2016-12-21
Business Address
-- KELLY SORENSEN IBCLC
23582 RAPALLA CT
ATHOL, ID 83801-7002
Phone number: 909-553-2113
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Mailing Address
-- KELLY SORENSEN IBCLC
23582 RAPALLA CT
ATHOL, ID 83801-7002
Phone number: 909-553-2113
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