Individual
ANITA MIEKO SOUTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
623 VERNON ST APT 312, ROSEVILLE, CA 95678-2367
(916) 500-9691
Mailing address
623 VERNON ST APT 312, ROSEVILLE, CA 95678-2367
(916) 500-9691
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
374J00000X
Doula
Primary
—
—
Other
Enumeration date
01/05/2024
Last updated
01/06/2024
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