=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063390904
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LEARN TO LATCH LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/26/2025
-----------------------------------------------------
Last Update Date | 08/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 609 W MEMORIAL RD
-----------------------------------------------------
City | OKLAHOMA CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73114-2006
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-615-0007
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11805 N AIR DEPOT BLVD
-----------------------------------------------------
City | EDMOND
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73013-8330
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-615-0007
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MICHELLE WILD
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 405-314-6592
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174N00000X
-----------------------------------------------------
Taxonomy Name | Lactation Consultant (Non-RN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------