Provider Demographics
NPI:1255907861
Name:JOURET, LAURA (IBCLC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:JOURET
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:WHITLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:148 RANCHO LORENA DR
Mailing Address - Street 2:
Mailing Address - City:LORENA
Mailing Address - State:TX
Mailing Address - Zip Code:76655-3556
Mailing Address - Country:US
Mailing Address - Phone:702-374-9894
Mailing Address - Fax:
Practice Address - Street 1:1525 AUSTIN AVE
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76701-1711
Practice Address - Country:US
Practice Address - Phone:254-753-1987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-300847174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
L-300847OtherIBCLC