Provider Demographics
NPI:1912756776
Name:OUELLETTE LAMONTAGNE, DANA ELIZABETH (IBCLC)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:ELIZABETH
Last Name:OUELLETTE LAMONTAGNE
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 HEPWORTH ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-7810
Mailing Address - Country:US
Mailing Address - Phone:860-371-1740
Mailing Address - Fax:
Practice Address - Street 1:192 HEPWORTH ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-7810
Practice Address - Country:US
Practice Address - Phone:860-371-1740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-157148174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN