Healthcare Provider Details

I. General information

NPI: 1780951012
Provider Name (Legal Business Name): BREASTFEEDING CENTER FOR GREATER WASHINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2011
Last Update Date: 12/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2141 K ST NW SUITE 3
WASHINGTON DC
20037-1810
US

IV. Provider business mailing address

2141 K ST NW SUITE 3
WASHINGTON DC
20037-1810
US

V. Phone/Fax

Practice location:
  • Phone: 202-293-5182
  • Fax:
Mailing address:
  • Phone: 202-293-5182
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number19512891
License Number StateVA

VIII. Authorized Official

Name: PATRICIA SHELLY
Title or Position: DIRECTOR/FOUNDER
Credential: IBCLC, RN
Phone: 202-293-5182