Provider Demographics
NPI:1962846675
Name:SWEET, MARY BETH (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:MARY BETH
Middle Name:
Last Name:SWEET
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 1:24806 HORSESHOE LN
Mailing Address - Street 2:
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-1117
Mailing Address - Country:US
Mailing Address - Phone:661-803-6380
Mailing Address - Fax:
Practice Address - Street 1:24806 HORSESHOE LN
Practice Address - Street 2:
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-1117
Practice Address - Country:US
Practice Address - Phone:661-803-6380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN