Healthcare Provider Details

I. General information

NPI: 1881940799
Provider Name (Legal Business Name): SARA DALE-BLEY IBCLC, RLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2012
Last Update Date: 07/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21530 E 46TH AVE
DENVER CO
80249-8066
US

IV. Provider business mailing address

PO BOX 460367
DENVER CO
80246-0367
US

V. Phone/Fax

Practice location:
  • Phone: 303-731-6657
  • Fax:
Mailing address:
  • Phone: 303-731-6657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: