Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 203417 |
NPI | 1376957126 |
---|---|
Provider Name | Molly Lynn Breuer |
First Address | Glen Haven, WI 53810-9718 |
Second Address | Glen Haven, WI 53810-9718 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2014 |
Last Update Date | 19/06/2014 |