MEDICARE: WENDY MCHALE IBCLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174N00000X	Lactation Consultant (Non-RN)	11183792	OH

General Provider Information

NPI Number	:	1306116629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY MCHALE IBCLC

Provider Business Mailing Address
First Line	:	6585 AMBAR AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45230-2820
Country	:	US
Telephone Number	:	513-295-4101
Fax Number	:

Provider Business Practice Location Address
First Line	:	4244 HAMILTON AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45223-2048
Country	:	US
Telephone Number	:	513-295-4101
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2012
Last Update Date	:	01/03/2012

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