Individual
MRS. MICHELE GAUDETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,IBCLC
Contact information
Practice address
4024 PENNY ROYAL DR, FORT WORTH, TX 76244-6636
(817) 217-5027
Mailing address
4024 PENNY ROYAL DR, FORT WORTH, TX 76244-6636
(817) 217-5027
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
710796
TX
Other
Enumeration date
01/15/2020
Last updated
01/15/2020
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