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General NPI Number Information
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NPI Number | 1790574531
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Entity Type | Organization
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Legal Business Name | STEPHANIE SIMON
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Dates
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Enumeration Date | 05/06/2025
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 2302 TIBBETTS WICK RD
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City | GIRARD
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State | OH
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Zip | 44420-1231
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Country | US
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Telephone | 330-203-1880
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Fax | 866-419-3574
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Provider Business Mailing Address
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Address Line | 1426 SODOM HUTCHINGS RD
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City | GIRARD
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State | OH
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Zip | 44420-1348
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Country | US
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Telephone | 330-240-6198
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Fax | 866-419-3574
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Authorized Official
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Title or Position | CEO/IBCLC
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Name | STEPHANIE SIMON
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Credential | RN, IBCLC
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Telephone | 330-240-6198
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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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