Healthcare Provider Details

I. General information

NPI: 1386303378
Provider Name (Legal Business Name): ALICIA C LAMONDA IBCLC, RN, CPD, PMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2021
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 DORSET HTS
SOUTH BURLINGTON VT
05403-8121
US

IV. Provider business mailing address

320 DORSET HTS
SOUTH BURLINGTON VT
05403-8121
US

V. Phone/Fax

Practice location:
  • Phone: 413-884-4259
  • Fax:
Mailing address:
  • Phone: 413-884-4259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number026.0151512
License Number StateVT
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number83-2997014
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: