Provider Demographics
NPI:1447536610
Name:MARIAN, CHERYL DAWN (IBCLC, RLC)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:DAWN
Last Name:MARIAN
Suffix:
Gender:F
Credentials:IBCLC, RLC
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:DAWN
Other - Last Name:MARIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CLC, CLE
Mailing Address - Street 1:519 BONNIEVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-2222
Mailing Address - Country:US
Mailing Address - Phone:330-823-1038
Mailing Address - Fax:
Practice Address - Street 1:519 BONNIEVIEW AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-2222
Practice Address - Country:US
Practice Address - Phone:330-823-1038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
11051280174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
11051280OtherIBCLC NUMBER CERTIFICATION