Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 11122306 | CA |
NPI | 1184063091 |
---|---|
Provider Name | Mrs. Deborah Sue Rovin |
First Address | Calabasas, CA 91302-3018 |
Second Address | Calabasas, CA 91302-3018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2013 |
Last Update Date | 24/06/2013 |