Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-82263 |
NPI | 1073987624 |
---|---|
Provider Name | Halina Vaughan |
First Address | Hastings, MI 49058-9423 |
Second Address | Hastings, MI 49058-9423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2015 |
Last Update Date | 22/09/2016 |