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General NPI Number Information
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NPI Number | 1104293521
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Entity Type | Individual
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Provider Name | ELIZABETH CABLE IBCLC
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Gender | Female
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 27 POND ST
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City | BREWSTER
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State | MA
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Zip | 02631-2452
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Country | US
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Telephone | 774-207-7124
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 135
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City | KINGSTON
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State | MA
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Zip | 02364-0135
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Country | US
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Telephone | 774-207-7124
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number | 38429
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License Number State | MA
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