Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mia Korinne Roetherford

Individual provider Lactation Consultant (Non-RN) · NPI 1477058394

Mia Korinne Roetherford is a Lactation Consultant (Non-RN) in Detroit, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2018
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Practice location Address checks out

18697 Sunderland Rd
Detroit, MI 48219-2816
Phone: (313) 587-0497
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Lactation Consultant (Non-RN) (primary) Taxonomy 174N00000X · Licence L112282 (MI)

Record details

NPI number1477058394
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 25, 2018
Last updated in NPPESMarch 25, 2018

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