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General NPI Number Information
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NPI Number | 1760182604
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Entity Type | Organization
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Legal Business Name | THE BREAST CHOICE LACTATION SERVICES
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Dates
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Enumeration Date | 03/08/2023
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 1636 N HAMPTON RD STE 227
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City | DESOTO
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State | TX
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Zip | 75115-8601
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Country | US
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Telephone | 972-765-8195
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Fax |
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Provider Business Mailing Address
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Address Line | 1636 N HAMPTON RD STE 227
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City | DESOTO
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State | TX
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Zip | 75115-8601
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Country | US
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Telephone | 972-765-8195
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | TIFFANI DICKERSON
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Credential | RN-IBCLC
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Telephone | 972-765-8195
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 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 #4
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #5
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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 #6
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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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