Healthcare Provider Details

I. General information

NPI: 1144013525
Provider Name (Legal Business Name): THE LACTATION LADY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2025
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1027 HOPE CT
BOYD TX
76023-1010
US

IV. Provider business mailing address

1027 HOPE CT
BOYD TX
76023-1010
US

V. Phone/Fax

Practice location:
  • Phone: 432-559-8178
  • Fax:
Mailing address:
  • Phone: 432-559-8178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateNULL

VIII. Authorized Official

Name: HAYLIE CRAWFORD
Title or Position: IBCLC
Credential: RN
Phone: 432-559-8178