Provider Demographics
NPI:1558739391
Name:SPATH, ALISON (CD(DONA), IBCLC)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:SPATH
Suffix:
Gender:F
Credentials:CD(DONA), IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 ELMDORF AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14619-1817
Mailing Address - Country:US
Mailing Address - Phone:585-451-9968
Mailing Address - Fax:
Practice Address - Street 1:681 N WINTON RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-7856
Practice Address - Country:US
Practice Address - Phone:585-451-9968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-10
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226681174N00000X
IL10734374J00000X
L-126886174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
10734OtherDONA INTERNATIONAL
226681OtherACADEMY OF LACTATION POLICY AND PRACTICE
L-126886OtherIBLCE