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General NPI Number Information
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NPI Number | 1669001459
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Entity Type | Individual
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Provider Name | JESSICA LOU BREADY CPM, IBCLC, CD
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Gender | Female
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Dates
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Enumeration Date | 04/03/2020
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 75 CHESTERFIELD RD
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City | NORTHBOROUGH
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State | MA
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Zip | 01532-2257
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Country | US
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Telephone | 508-981-9298
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Fax | 508-556-1403
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Provider Business Mailing Address
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Address Line | 75 CHESTERFIELD RD
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City | NORTHBOROUGH
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State | MA
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Zip | 01532-2257
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Country | US
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Telephone | 508-981-9298
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Fax | 508-556-1403
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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 | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 19080012
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License Number State | MA
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