Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | 282392 | VA |
Y | 174N00000X | Lactation Consultant | L-132108 | VA |
NPI | 1215491238 |
---|---|
Provider Name | Erin Elizabeth Vandelinde |
First Address | Roanoke, VA 24018-7745 |
Second Address | Roanoke, VA 24018-7745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2019 |
Last Update Date | 23/01/2019 |