Provider Demographics
NPI:1255711214
Name:GARRETT, SUZI (IBCLC)
Entity type:Individual
Prefix:
First Name:SUZI
Middle Name:
Last Name:GARRETT
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 1:650 TENNIS AVE
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-1705
Mailing Address - Country:US
Mailing Address - Phone:215-572-6318
Mailing Address - Fax:267-339-0335
Practice Address - Street 1:650 TENNIS AVE
Practice Address - Street 2:
Practice Address - City:GLENSIDE
Practice Address - State:PA
Practice Address - Zip Code:19038-1705
Practice Address - Country:US
Practice Address - Phone:215-572-6318
Practice Address - Fax:267-339-0335
Is Sole Proprietor?:No
Enumeration Date:2015-06-04
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN