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General NPI Number Information
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NPI Number | 1922764992
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Entity Type | Organization
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Legal Business Name | MILK GUIDE LACTATION OF TENNESSEE LLC
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Dates
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Enumeration Date | 11/12/2021
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | 316 E BROAD ST
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City | COOKEVILLE
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State | TN
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Zip | 38501-3304
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Country | US
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Telephone | 574-315-3196
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Fax |
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Provider Business Mailing Address
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Address Line | 10275 PEOTONE DR
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City | GRANGER
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State | IN
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Zip | 46530-7744
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KRISTIN SZERSZEN
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Credential |
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Telephone | 574-315-3196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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