Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 11118801 | MI |
NPI | 1063781516 |
---|---|
Provider Name | Keleigh Lee |
First Address | Ypsilanti, MI 48198-9414 |
Second Address | Ypsilanti, MI 48198-9414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2011 |
Last Update Date | 28/12/2011 |