Provider Demographics
NPI:1346812302
Name:INGLIS, CAITLIN ANN (CLC)
Entity Type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:ANN
Last Name:INGLIS
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 BENNETT ST
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-2622
Mailing Address - Country:US
Mailing Address - Phone:207-841-8361
Mailing Address - Fax:
Practice Address - Street 1:200 ELM ST
Practice Address - Street 2:
Practice Address - City:NORTH CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-1303
Practice Address - Country:US
Practice Address - Phone:207-841-8361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-10
Last Update Date:2021-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA310148174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN