Provider Demographics
NPI:1063620326
Name:ANDREWS, GRETCHEN ANNE (IBCLC)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:ANNE
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-5134
Mailing Address - Country:US
Mailing Address - Phone:951-533-3606
Mailing Address - Fax:909-793-1266
Practice Address - Street 1:105 S CENTER ST
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5134
Practice Address - Country:US
Practice Address - Phone:951-533-3606
Practice Address - Fax:909-793-1266
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist