Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1356630750 |
---|---|
Provider Name | Mrs. Laura Jean Spitzfaden |
First Address | Charlotte, MI 48813-8315 |
Second Address | Charlotte, MI 48813-8315 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2011 |
Last Update Date | 06/04/2011 |