Provider Demographics
NPI:1578126785
Name:SCARINO LEMONS, JOHANNA MARIE (PHD, IBCLC)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:MARIE
Last Name:SCARINO LEMONS
Suffix:
Gender:F
Credentials:PHD, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:NEWRY
Mailing Address - State:SC
Mailing Address - Zip Code:29665-0100
Mailing Address - Country:US
Mailing Address - Phone:864-280-9116
Mailing Address - Fax:
Practice Address - Street 1:504 WILLOW BRANCH LN
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29672
Practice Address - Country:US
Practice Address - Phone:864-401-5738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-15
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-144056174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN