Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 108-66501 | CO |
NPI | 1083949705 |
---|---|
Provider Name | Ms. Diane S Michel |
First Address | Boulder, CO 80303-2847 |
Second Address | Boulder, CO 80303-2847 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2009 |
Last Update Date | 04/09/2012 |