Provider Demographics
NPI:1992176705
Name:JILLIAN HATCH, LACTATION CONSULTANT
Entity type:Organization
Organization Name:JILLIAN HATCH, LACTATION CONSULTANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RNC-OB, IBCLC
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:RNC-OB, IBCLC
Authorized Official - Phone:610-733-6789
Mailing Address - Street 1:2245 CAMBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-2904
Mailing Address - Country:US
Mailing Address - Phone:610-733-6789
Mailing Address - Fax:
Practice Address - Street 1:2245 CAMBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-2904
Practice Address - Country:US
Practice Address - Phone:610-733-6789
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA11211430251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health