Healthcare Provider Details

I. General information

NPI: 1023783354
Provider Name (Legal Business Name): LACTATION GODDESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2021
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 CRAWFORD DR
SICKLERVILLE NJ
08081-4417
US

IV. Provider business mailing address

28 CRAWFORD DR
SICKLERVILLE NJ
08081-4417
US

V. Phone/Fax

Practice location:
  • Phone: 856-481-2391
  • 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: NASHEEDA POLLARD
Title or Position: OWNER
Credential: IBCLC, MPH
Phone: 856-481-2391