Healthcare Provider Details

I. General information

NPI: 1043797863
Provider Name (Legal Business Name): MARGARET MARIE SCHLESSMAN EMMERICH IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 07/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1878 S EMERSON ST
DENVER CO
80210-3210
US

IV. Provider business mailing address

1878 S EMERSON ST
DENVER CO
80210-3210
US

V. Phone/Fax

Practice location:
  • Phone: 303-918-1860
  • Fax:
Mailing address:
  • Phone: 303-918-1860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-109594
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: