Healthcare Provider Details

I. General information

NPI: 1861953531
Provider Name (Legal Business Name): THE BREASTFEEDING DEN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 01/31/2024
Certification Date: 09/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 HAMILL RD STE 344W
BALTIMORE MD
21210-1806
US

IV. Provider business mailing address

1810 ROLAND AVE
BALTIMORE MD
21204-3529
US

V. Phone/Fax

Practice location:
  • Phone: 410-246-2659
  • Fax: 443-440-5869
Mailing address:
  • Phone: 410-929-2455
  • Fax: 443-440-5869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KATHERINE LINDA
Title or Position: OWNER
Credential: IBCLC
Phone: 410-929-2455