Provider Demographics
NPI:1679062194
Name:CONNECTIONS LACTATION SERVICES LLC
Entity Type:Organization
Organization Name:CONNECTIONS LACTATION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LACTATION CONSULTANT, SLP
Authorized Official - Prefix:
Authorized Official - First Name:BREA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARLSON
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP, IBCLC
Authorized Official - Phone:765-267-1977
Mailing Address - Street 1:1402 DURHAM DR
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-3510
Mailing Address - Country:US
Mailing Address - Phone:765-267-1977
Mailing Address - Fax:888-971-3923
Practice Address - Street 1:2837 HENDERSON ST
Practice Address - Street 2:
Practice Address - City:WEST LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47906-1540
Practice Address - Country:US
Practice Address - Phone:765-267-1977
Practice Address - Fax:888-971-3923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-10
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INL-127002174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty