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General NPI Number Information
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NPI Number | 1306767736
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Entity Type | Organization
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Legal Business Name | LAUREL TREE LACTATION, LLC
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Dates
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Enumeration Date | 07/22/2026
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | 530 BROOKMEADE CT
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City | TROY
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State | OH
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Zip | 45373
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Country | US
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Telephone | 937-216-9455
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Fax |
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Provider Business Mailing Address
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Address Line | 1841 W MAIN ST # 178
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City | TROY
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State | OH
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Zip | 45373-2303
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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 | ALEXANDRIA KELLER
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Credential | BSN,RN,IBCLC
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Telephone | 937-216-9455
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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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