Provider Demographics
NPI:1457161622
Name:LACTATION PERSONALIZED LLC
Entity type:Organization
Organization Name:LACTATION PERSONALIZED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, IBCLC
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:MARISSA
Authorized Official - Last Name:HELD
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC
Authorized Official - Phone:203-548-0354
Mailing Address - Street 1:48 PALMER ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06907-2034
Mailing Address - Country:US
Mailing Address - Phone:203-715-6333
Mailing Address - Fax:888-527-6218
Practice Address - Street 1:48 PALMER ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06907-2034
Practice Address - Country:US
Practice Address - Phone:203-548-0354
Practice Address - Fax:888-527-6218
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant