Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | OH |
NPI | 1043722242 |
---|---|
Provider Name | Amy Lynne Labuda |
First Address | Cleveland, OH 44111-5738 |
Second Address | Middleburg Heights, OH 44130-3639 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2017 |
Last Update Date | 27/10/2017 |