Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant |
NPI | 1023783784 |
---|---|
Provider Name | Latisha L Michel |
First Address | Newport, RI 02840-1174 |
Second Address | Newport, RI 02840-1174 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2021 |
Last Update Date | 13/08/2021 |