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General NPI Number Information
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NPI Number | 1467959163
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Entity Type | Organization
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Legal Business Name | BOSTON LACTATION, LLC
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Dates
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Enumeration Date | 04/09/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 143 MARY ST
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City | ARLINGTON
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State | MA
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Zip | 02474-8847
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Country | US
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Telephone | 781-632-7239
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Fax |
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Provider Business Mailing Address
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Address Line | 143 MARY ST
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City | ARLINGTON
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State | MA
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Zip | 02474-8847
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Country | US
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Telephone | 781-632-7239
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. HEATHER BINGHAM
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Credential | IBCLC
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Telephone | 781-632-7239
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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 | 10873023
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License Number State | MA
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