Provider Demographics
NPI:1952788523
Name:MILK MOJO
Entity Type:Organization
Organization Name:MILK MOJO
Other - Org Name:MILK MOJO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, LACTATION CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:ERICKA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:STURSA-PATENAUDE
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN, IBCLC, RLC
Authorized Official - Phone:210-251-7452
Mailing Address - Street 1:9002 ACORN FOREST DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-2724
Mailing Address - Country:US
Mailing Address - Phone:210-251-7452
Mailing Address - Fax:
Practice Address - Street 1:9002 ACORN FOREST DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-2724
Practice Address - Country:US
Practice Address - Phone:210-251-7452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-02
Last Update Date:2015-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX867436163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty