Provider Demographics
NPI:1487013900
Name:HAMBLETON, NAOMI C (IBCLC)
Entity Type:Individual
Prefix:MS
First Name:NAOMI
Middle Name:C
Last Name:HAMBLETON
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 1:3117 GRASS MARSH DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-8128
Mailing Address - Country:US
Mailing Address - Phone:845-661-2491
Mailing Address - Fax:
Practice Address - Street 1:3117 GRASS MARSH DR
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-8128
Practice Address - Country:US
Practice Address - Phone:845-661-2491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCL-78262174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN