Individual
THERESA HOPE MADOUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN, IBCLC
Contact information
Practice address
3362 PARKLAND DR, WEST BLOOMFIELD, MI 48322-1828
(248) 425-0702
Mailing address
3362 PARKLAND DR, WEST BLOOMFIELD, MI 48322-1828
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-157742
MI
163WN0002X
Neonatal Intensive Care Registered Nurse
4704321895
MI
Other
Enumeration date
09/30/2020
Last updated
09/30/2020
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