Provider Demographics
NPI:1922575919
Name:HOBBS, HEATHER JO (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:JO
Last Name:HOBBS
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:JO
Other - Last Name:FLOWERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10630 LITTLE PATUXENT PKWY STE 128
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-6233
Mailing Address - Country:US
Mailing Address - Phone:301-928-4952
Mailing Address - Fax:
Practice Address - Street 1:10630 LITTLE PATUXENT PKWY STE 128
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-6233
Practice Address - Country:US
Practice Address - Phone:301-928-4952
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-27
Last Update Date:2018-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDL-49790174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN