Healthcare Provider Details

I. General information

NPI: 1003726076
Provider Name (Legal Business Name): JACQUELINE LINDAMOOD RD, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

365 RIVER ST
SPRINGFIELD VT
05156
US

IV. Provider business mailing address

966 PLAINS RD
PERKINSVILLE VT
05151-9705
US

V. Phone/Fax

Practice location:
  • Phone: 603-315-0988
  • Fax:
Mailing address:
  • Phone: 603-315-0988
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: