Organization
PROFESSIONAL BREASTFEEDING SUPPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA ANZICEK RN IBCLC (OWNER/IBCLC)
(248) 795-1984
Entity
Organization
Contact information
Practice address
4630 W WALTON BLVD, WATERFORD, MI 48329-3535
(248) 795-1984
Mailing address
4630 W WALTON BLVD, WATERFORD, MI 48329-3535
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
Other
Enumeration date
03/03/2016
Last updated
03/03/2016
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