Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-32754 | CA |
NPI | 1073908075 |
---|---|
Provider Name | Mrs. Maree Makins |
First Address | Fremont, CA 94538-2299 |
Second Address | Fremont, CA 94538-2299 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2015 |
Last Update Date | 06/04/2015 |