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MIA KORINNE ROETHERFORD
NPI 1477058394
Lactation Consultant, Non-RN in Detroit, MI

Active since March 25, 2018
18697 SUNDERLAND RD, DETROIT, MI 48219(313) 587-0497 Get Directions Write a Review

NPPES record last updated: March 25, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mia Korinne Roetherford NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIA KORINNE ROETHERFORD (NPI 1477058394) is an individual lactation consultant, non-rn provider in Detroit, Michigan, licensed in Michigan (L112282) and active in the NPI registry since March 2018.

NPPES Registry Identity

NPI1477058394
Entity TypeIndividualFemale
Primary Taxonomy174N00000X
Provider Legal NameMIA KORINNE ROETHERFORD
Location Address18697 SUNDERLAND RDDetroit, MI 48219-2816
Mailing Address18697 Sunderland RdDetroit, MI 48219-2816 · (313) 587-0497
Phone(313) 587-0497
Sole ProprietorYes
Enumeration DateMarch 25, 2018
✔ NPI 1477058394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLactation Consultant, Non-RNOther Service Providers
Taxonomy Code174N00000X
License✔ Licensed in MI · L112282
Definition
An individual trained to provide breastfeeding assistance services to both mothers and infants. Lactation Consultants are not required to be nurses and are trained through specific courses of education. The Lactation Consultant may have additional certification through a national or international organization.
18697 SUNDERLAND RD, Detroit, MI 48219
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mia Roetherford's NPI number?

The NPI number for Mia Roetherford is 1477058394. It was assigned to this individual provider in the NPPES registry on March 25, 2018.

Where is Mia Roetherford located?

Mia Roetherford practices at 18697 Sunderland Rd, Detroit, MI 48219. The listed phone number is (313) 587-0497.

What is Mia Roetherford's specialty?

The primary specialty registered for this NPI is Lactation Consultant, Non-RN with taxonomy code 174N00000X.

When was this NPI record last updated?

The NPPES record for Mia Roetherford was last updated on March 25, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.