Provider Demographics
NPI:1689373060
Name:LOGGHE, ANA HOPE (IBCLC, LMT)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:HOPE
Last Name:LOGGHE
Suffix:
Gender:F
Credentials:IBCLC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12B ECKARDS WAY
Mailing Address - Street 2:
Mailing Address - City:ESPANOLA
Mailing Address - State:NM
Mailing Address - Zip Code:87532-9878
Mailing Address - Country:US
Mailing Address - Phone:505-692-5697
Mailing Address - Fax:
Practice Address - Street 1:905 CALLE ARMADA
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-3460
Practice Address - Country:US
Practice Address - Phone:505-753-0505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMT9649225700000X
NML-127089174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist