Provider Demographics
NPI:1164775987
Name:MACLEAN, MAIRE (IBCLC)
Entity Type:Individual
Prefix:
First Name:MAIRE
Middle Name:
Last Name:MACLEAN
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 1:62 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAMILTON
Mailing Address - State:MA
Mailing Address - Zip Code:01982-2119
Mailing Address - Country:US
Mailing Address - Phone:978-500-5740
Mailing Address - Fax:
Practice Address - Street 1:62 UNION ST
Practice Address - Street 2:
Practice Address - City:SOUTH HAMILTON
Practice Address - State:MA
Practice Address - Zip Code:01982-2119
Practice Address - Country:US
Practice Address - Phone:978-500-5740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-17
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11177366174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN