MEDICARE: MS. LIN W. COOK IBCLC,RLC,CLC,AAHCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula
2	174N00000X	Lactation Consultant (Non-RN)

General Provider Information

NPI Number	:	1942537535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LIN W. COOK IBCLC,RLC,CLC,AAHCC

Provider Business Mailing Address
First Line	:	1220 MAXWELL ST
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-4151
Country	:	US
Telephone Number	:	843-744-4777
Fax Number	:	843-744-4777

Provider Business Practice Location Address
First Line	:	1220 MAXWELL ST
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-4151
Country	:	US
Telephone Number	:	843-744-4777
Fax Number	:	843-744-4777

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2009
Last Update Date	:	11/20/2012

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