Provider Demographics
NPI:1376186288
Name:RALEIGH, CLAUDIA SMYCZEK (IBCLC)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:SMYCZEK
Last Name:RALEIGH
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 1:1709 MICHAUX RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7639
Mailing Address - Country:US
Mailing Address - Phone:248-376-8314
Mailing Address - Fax:
Practice Address - Street 1:1709 MICHAUX RD
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7639
Practice Address - Country:US
Practice Address - Phone:248-376-8314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-142596174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
L-142596OtherINTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS