Provider Demographics
NPI:1437818895
Name:ASHLEY BENZ LACTATION CONSULTANT, LLC
Entity Type:Organization
Organization Name:ASHLEY BENZ LACTATION CONSULTANT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ASHLEY
Authorized Official - Last Name:BENZ
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:502-417-3769
Mailing Address - Street 1:9302 NEW LA GRANGE RD STE D
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40242-3652
Mailing Address - Country:US
Mailing Address - Phone:502-417-3769
Mailing Address - Fax:
Practice Address - Street 1:9302 NEW LA GRANGE RD STE D
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40242-3652
Practice Address - Country:US
Practice Address - Phone:502-417-3769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASHLEY BENZ LACTATION CONSULTANT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty