Provider Demographics
NPI:1679923692
Name:LAMB, LAURA RUTH (BSW, IBCLC, RLC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:RUTH
Last Name:LAMB
Suffix:
Gender:F
Credentials:BSW, IBCLC, RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7308 BUCKNELL DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-1632
Mailing Address - Country:US
Mailing Address - Phone:512-775-4881
Mailing Address - Fax:
Practice Address - Street 1:7308 BUCKNELL DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-1632
Practice Address - Country:US
Practice Address - Phone:512-775-4881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
L-22284OtherLACTATION CONSULTANT