Healthcare Provider Details

I. General information

NPI: 1245937333
Provider Name (Legal Business Name): MINDFUL MOTHERHOOD LACTATION AND INFANT FEEDING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2023
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 CADMAN DR
MIDDLETOWN DE
19709-1529
US

IV. Provider business mailing address

911 CADMAN DR
MIDDLETOWN DE
19709-1529
US

V. Phone/Fax

Practice location:
  • Phone: 302-245-2409
  • Fax:
Mailing address:
  • Phone:
  • 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: STEPHANIE TROST
Title or Position: OWNER AND FOUNDER
Credential: M.S., CCC-SLP, IBCLC
Phone: 302-245-2409