Provider Demographics
NPI:1194299628
Name:MIRANDA, ALISON (IBCLC)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:MIRANDA
Suffix:
Gender:
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 WILBUR AVE
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-2163
Mailing Address - Country:US
Mailing Address - Phone:401-252-9332
Mailing Address - Fax:
Practice Address - Street 1:1380 WILBUR AVE
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-2163
Practice Address - Country:US
Practice Address - Phone:401-252-9332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-17
Last Update Date:2025-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty