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General NPI Number Information
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NPI Number | 1154845048
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Entity Type | Individual
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Provider Name | LESLIE RITA DURBIN CLC
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Gender | Female
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Dates
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Enumeration Date | 08/01/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2750 E 10TH ST
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City | HOBART
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State | IN
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Zip | 46342-5324
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Country | US
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Telephone | 219-718-8883
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Fax |
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Provider Business Mailing Address
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Address Line | 2750 E 10TH ST
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City | HOBART
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State | IN
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Zip | 46342-5324
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Country | US
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Telephone | 219-718-8883
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number | 67018105A
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number | ALPP-254322
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License Number State |
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