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General NPI Number Information
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NPI Number | 1093671273
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Entity Type | Organization
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Legal Business Name | THE MAMA COACH - CHRISTINE FENNER LLC
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Dates
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Enumeration Date | 12/31/2025
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 11714 BOUDREAUX RD # 224
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City | TOMBALL
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State | TX
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Zip | 77375-7369
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Country | US
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Telephone | 281-516-8406
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Fax |
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Provider Business Mailing Address
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Address Line | 27708 TOMBALL PKWY 266
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City | TOMBALL
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State | TX
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Zip | 77375
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REBECCA CHRISTINE FENNER
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Credential | BSN,IBCLC
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Telephone | 281-516-8406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number |
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License Number State |
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