Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1174974034 |
---|---|
Provider Name | Jillian Ondreyka |
First Address | Ypsilanti, MI 48198-9317 |
Second Address | Ypsilanti, MI 48198-9317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2016 |
Last Update Date | 12/01/2019 |