Provider Demographics
NPI:1376360461
Name:AGUILAR, DELANIE R (LM CPM)
Entity type:Individual
Prefix:MRS
First Name:DELANIE
Middle Name:R
Last Name:AGUILAR
Suffix:
Gender:F
Credentials:LM CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:HUDSONVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49426-8742
Mailing Address - Country:US
Mailing Address - Phone:616-240-6547
Mailing Address - Fax:
Practice Address - Street 1:1575 JACKSON ST
Practice Address - Street 2:
Practice Address - City:HUDSONVILLE
Practice Address - State:MI
Practice Address - Zip Code:49426-8742
Practice Address - Country:US
Practice Address - Phone:616-240-6547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-20
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7601000141176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife