Provider Demographics
NPI:1376994632
Name:WHITLEY, LEAH (IBCLC)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:WHITLEY
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 1:2303 SHAKESPEARE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1114
Mailing Address - Country:US
Mailing Address - Phone:832-452-0815
Mailing Address - Fax:
Practice Address - Street 1:2303 SHAKESPEARE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1114
Practice Address - Country:US
Practice Address - Phone:832-452-0815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN