Provider Demographics
NPI:1679224430
Name:FEAR, ADRIAN (IBCLC)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:FEAR
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 1:395 WHITEWATER ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48381-2491
Mailing Address - Country:US
Mailing Address - Phone:586-651-3910
Mailing Address - Fax:
Practice Address - Street 1:395 WHITEWATER ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MI
Practice Address - Zip Code:48381-2491
Practice Address - Country:US
Practice Address - Phone:586-651-3910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-125078174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
L-125078OtherINTERNATIONAL BOARD CERTIFIED LACTATION CONSULTANT