Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | TALPP-34455 | CO |
NPI | 1083015119 |
---|---|
Provider Name | Stephanie Fleming |
First Address | Springfield, OR 97478-6899 |
Second Address | Springfield, OR 97478-6899 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2014 |
Last Update Date | 08/09/2014 |