Provider Demographics
NPI:1588248298
Name:GUIDED LACTATION, LLC
Entity type:Organization
Organization Name:GUIDED LACTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LACTATION CONSULTANT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, IBCLC
Authorized Official - Phone:281-703-2546
Mailing Address - Street 1:14011 CONNER PARK DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-8228
Mailing Address - Country:US
Mailing Address - Phone:281-703-2546
Mailing Address - Fax:844-640-0673
Practice Address - Street 1:14011 CONNER PARK DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-8228
Practice Address - Country:US
Practice Address - Phone:281-703-2546
Practice Address - Fax:844-640-0673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-09
Last Update Date:2021-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty