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General NPI Number Information
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NPI Number | 1669321659
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Entity Type | Organization
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Legal Business Name | SPRING ROOTS LACTATION LLC
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Dates
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Enumeration Date | 01/23/2026
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 1718 ABERDEEN CIR
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City | CROFTON
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State | MD
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Zip | 21114-1618
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Country | US
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Telephone | 443-292-2412
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Fax |
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Provider Business Mailing Address
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Address Line | 1718 ABERDEEN CIR
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City | CROFTON
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State | MD
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Zip | 21114-1618
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Country | US
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Telephone | 443-292-2412
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | BETHANY MCGOWAN
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Credential | RN, IBCLC
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Telephone | 443-292-2412
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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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