Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | ALPP-254322 |
NPI | 1154845048 |
---|---|
Provider Name | Leslie Rita Durbin |
First Address | Hobart, IN 46342-5324 |
Second Address | Hobart, IN 46342-5324 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2017 |
Last Update Date | 01/08/2017 |