Provider Demographics
NPI:1588037303
Name:BARUGH, AMANDA (IBCLC)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:BARUGH
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 1:1005 LOGANSPORT ST
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-4515
Mailing Address - Country:US
Mailing Address - Phone:936-645-3423
Mailing Address - Fax:
Practice Address - Street 1:1005 LOGANSPORT ST
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-4515
Practice Address - Country:US
Practice Address - Phone:936-645-3423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-02
Last Update Date:2015-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN