Provider Demographics
NPI:1639931678
Name:WEINBERG, STEPHANIE (IBCLC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:WEINBERG
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 1:5402 WEHAWKEN RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-3138
Mailing Address - Country:US
Mailing Address - Phone:202-492-8422
Mailing Address - Fax:
Practice Address - Street 1:5402 WEHAWKEN RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-3138
Practice Address - Country:US
Practice Address - Phone:202-492-8422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-314244174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN