Provider Demographics
NPI:1578885745
Name:SCHNELL, ALYSSA (IBCLC)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:SCHNELL
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 N FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:WEBSTER GROVES
Mailing Address - State:MO
Mailing Address - Zip Code:63119-1930
Mailing Address - Country:US
Mailing Address - Phone:314-614-2074
Mailing Address - Fax:
Practice Address - Street 1:812 N FOREST AVE
Practice Address - Street 2:
Practice Address - City:WEBSTER GROVES
Practice Address - State:MO
Practice Address - Zip Code:63119-1930
Practice Address - Country:US
Practice Address - Phone:314-614-2074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO10961595174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN