Provider Demographics
NPI:1437820792
Name:REBECCA MCCANN LACTATION, LLC
Entity Type:Organization
Organization Name:REBECCA MCCANN LACTATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCANN
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC, RN
Authorized Official - Phone:425-894-0946
Mailing Address - Street 1:4613 31ST RD S
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-1601
Mailing Address - Country:US
Mailing Address - Phone:425-894-0946
Mailing Address - Fax:
Practice Address - Street 1:4613 31ST RD S
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-1601
Practice Address - Country:US
Practice Address - Phone:425-894-0946
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-25
Last Update Date:2021-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty