Provider Demographics
NPI:1114463387
Name:LOVE AND WELLNESS LACTATION LTD.
Entity Type:Organization
Organization Name:LOVE AND WELLNESS LACTATION LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LACTATION CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIELBASA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, IBCLC
Authorized Official - Phone:484-894-7961
Mailing Address - Street 1:4005 SAPPHIRE LN
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-7744
Mailing Address - Country:US
Mailing Address - Phone:484-894-7961
Mailing Address - Fax:
Practice Address - Street 1:4005 SAPPHIRE LN
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-7744
Practice Address - Country:US
Practice Address - Phone:484-894-7961
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN592510163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty