Provider Demographics
NPI:1639868656
Name:MCCLESKEY, MEGHAN (CLC, IBCLC)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:MCCLESKEY
Suffix:
Gender:F
Credentials:CLC, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1606A KYNETTE DRIVE
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-4080
Mailing Address - Country:US
Mailing Address - Phone:817-715-8562
Mailing Address - Fax:
Practice Address - Street 1:1606A KYNETTE DRIVE
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-4080
Practice Address - Country:US
Practice Address - Phone:817-715-8562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
L-312628OtherIBLCE - INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS
335388OtherALPP - THE ACADEMY OF LACTATION POLICY & PRACTICE