Provider Demographics
NPI:1639538895
Name:MELE, LARA (IBCLC, RLC)
Entity Type:Individual
Prefix:MRS
First Name:LARA
Middle Name:
Last Name:MELE
Suffix:
Gender:F
Credentials:IBCLC, RLC
Other - Prefix:MS
Other - First Name:LARA
Other - Middle Name:
Other - Last Name:MICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:IBCLC, RLC
Mailing Address - Street 1:180 PINE HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607
Mailing Address - Country:US
Mailing Address - Phone:828-278-9048
Mailing Address - Fax:
Practice Address - Street 1:180 PINE HILL ROAD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607
Practice Address - Country:US
Practice Address - Phone:828-278-9048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL-60679174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN