Healthcare Provider Details

I. General information

NPI: 1093504342
Provider Name (Legal Business Name): RIVER VALLEY LACTATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2025
Last Update Date: 05/03/2025
Certification Date: 05/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1927 35TH AVE
OSCEOLA WI
54020-5600
US

IV. Provider business mailing address

1927 35TH AVE
OSCEOLA WI
54020-5600
US

V. Phone/Fax

Practice location:
  • Phone: 715-497-3593
  • Fax:
Mailing address:
  • Phone: 715-497-3593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name: KAYLI JO SCHOUNARD
Title or Position: LACTATION CONSULTANT
Credential: IBCLC
Phone: 715-497-3593