Individual
MRS. GINA MICHELLE BAUSANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11955 RAINTREE CT, SHELBY TOWNSHIP, MI 48315-1159
(586) 918-1377
Mailing address
11955 RAINTREE CT, SHELBY TOWNSHIP, MI 48315-1159
(586) 918-1377
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-316882
MI
Other
Enumeration date
03/27/2025
Last updated
03/27/2025
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