Provider Demographics
NPI:1073228268
Name:BAUMGART, CHRISTINE HAVERLY (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:HAVERLY
Last Name:BAUMGART
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 1:8 HIGH POINT LN
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-1135
Mailing Address - Country:US
Mailing Address - Phone:860-302-0553
Mailing Address - Fax:
Practice Address - Street 1:8 HIGH POINT LN
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-1135
Practice Address - Country:US
Practice Address - Phone:860-302-0553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTL-151624174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty