Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 312802 | MI |
NPI | 1245856731 |
---|---|
Provider Name | Jennifer Hoekstra |
First Address | Grand Rapids, MI 49508-1525 |
Second Address | Grand Rapids, MI 49508-1525 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2020 |
Last Update Date | 19/06/2020 |