Provider Demographics
NPI:1972883296
Name:SEGURA, LEAH (BSW,IBCLC,PCD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:
Last Name:SEGURA
Suffix:
Gender:F
Credentials:BSW,IBCLC,PCD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 BITLER ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-2701
Mailing Address - Country:US
Mailing Address - Phone:989-798-3375
Mailing Address - Fax:
Practice Address - Street 1:1428 BITLER ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-2701
Practice Address - Country:US
Practice Address - Phone:989-798-3375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
MIL-49515174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula