Healthcare Provider Details

I. General information

NPI: 1649099433
Provider Name (Legal Business Name): RACHEL ELENA BELSKUS IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2024
Last Update Date: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5995 N 78TH ST UNIT 2096
SCOTTSDALE AZ
85250-6151
US

IV. Provider business mailing address

14757 N 90TH PL
SCOTTSDALE AZ
85260-2701
US

V. Phone/Fax

Practice location:
  • Phone: 480-466-4386
  • Fax:
Mailing address:
  • Phone: 480-466-4386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License NumberL-315757
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: