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General NPI Number Information
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NPI Number | 1346054715
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Entity Type | Organization
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Legal Business Name | LACTATION CONSULTANT AT HOME, LLC
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 02/22/2025
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Provider Practice Location Address
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Address Line | 1200 HIGH RIDGE RD STE 2
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City | STAMFORD
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State | CT
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Zip | 06905-1202
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Country | US
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Telephone | 914-218-6231
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Fax | 203-349-2422
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Provider Business Mailing Address
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Address Line | 25 HETTIEFRED RD
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City | GREENWICH
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State | CT
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Zip | 06831-3258
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Country | US
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Telephone | 914-374-2714
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Fax | 203-349-2422
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Authorized Official
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Title or Position | IBCLC
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Name | CATHLEEN DIANE WALKER
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Credential | MA, RN, IBCLC
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Telephone | 914-374-2714
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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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