Healthcare Provider Details

I. General information

NPI: 1386868743
Provider Name (Legal Business Name): VISITING LACTATION CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 TAFT RD
STERLING MA
01564-2117
US

IV. Provider business mailing address

31 TAFT RD
STERLING MA
01564-2117
US

V. Phone/Fax

Practice location:
  • Phone: 978-422-9070
  • Fax:
Mailing address:
  • Phone: 978-422-9070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number238644
License Number StateMA

VIII. Authorized Official

Name: MS. DEBRA HOFFMAN PAGE
Title or Position: OWNER
Credential: RN, IBCLC
Phone: 978-422-9070