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NPI Code Detail

MEDICARE: BREASTFEEDING COUNSELOR

MEDICARE: BREASTFEEDING COUNSELOR
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
1253Z00000XIn Home Supportive Care Agency
2174N00000XLactation Consultant (Non-RN)

General Provider Information

NPI Number : 1982347779
Entity Type Code : Organization
Provider Name (Legal Business Name) : BREASTFEEDING COUNSELOR
Provider Business Mailing Address
First Line : 4100 SWISS AVE
Second Line :
City : DALLAS
State : TX
Zip : 75204-6661
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4100 SWISS AVE
Second Line :
City : DALLAS
State : TX
Zip : 75204-6661
Country : US
Telephone Number : 972-694-1429
Fax Number :
Authorized Official
Title or Position : OWNER/CEO
Name : ALYSSA N PERI
Credential : IBCLC
Telephone Number : 972-694-1429
Provider Enumeration Date : 04/19/2022
Last Update Date : 08/17/2023

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