Individual
MRS. LISA MARIE LEVY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
520 N SILVERY LN, DEARBORN, MI 48128-1538
(313) 850-8617
Mailing address
520 N SILVERY LN, DEARBORN, MI 48128-1538
(313) 850-8617
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
4704194473
MI
Other
Enumeration date
10/04/2018
Last updated
10/04/2018
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