Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-127037 | CO |
NPI | 1184149205 |
---|---|
Provider Name | Irene Dreith |
First Address | Ridgway, CO 81432-0373 |
Second Address | Ridgway, CO 81432-9458 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2017 |
Last Update Date | 09/08/2017 |