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General NPI Number Information
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NPI Number | 1376354803
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Entity Type | Organization
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Legal Business Name | BOUNTIFUL BEGINNINGS
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 1915 N 6TH ST
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City | WAUSAU
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State | WI
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Zip | 54403-3435
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Country | US
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Telephone | 715-891-4315
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Fax |
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Provider Business Mailing Address
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Address Line | 150011 PEREGRINE WAY
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City | WAUSAU
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State | WI
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Zip | 54401-6727
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Country | US
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Telephone | 715-891-4315
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Fax |
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Authorized Official
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Title or Position | LACATATION CONSULTANT
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Name | DR. ALEXIS BAUTCH
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Credential | IBCLC
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Telephone | 715-891-4315
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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 |
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License Number State |
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