Provider Demographics
NPI:1497079602
Name:BALDWIN LACTATION CONSULTANT SERVICES, LLC
Entity Type:Organization
Organization Name:BALDWIN LACTATION CONSULTANT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNATIONAL BOARD CERTIFIED LACTA
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRACIELA
Authorized Official - Middle Name:E
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC, RLC
Authorized Official - Phone:262-898-1722
Mailing Address - Street 1:3338 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53406-5464
Mailing Address - Country:US
Mailing Address - Phone:262-898-1722
Mailing Address - Fax:
Practice Address - Street 1:3338 OAKWOOD DR
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53406-5464
Practice Address - Country:US
Practice Address - Phone:262-898-1722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-16
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA10725859174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty