Provider Demographics
NPI:1295944528
Name:HAZELBAKER, ALISON (PHD, IBCLC, CST)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:HAZELBAKER
Suffix:
Gender:F
Credentials:PHD, IBCLC, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5115 OLENTANGY RIVER RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-3413
Mailing Address - Country:US
Mailing Address - Phone:614-326-3504
Mailing Address - Fax:614-326-3509
Practice Address - Street 1:5115 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-3413
Practice Address - Country:US
Practice Address - Phone:614-326-3504
Practice Address - Fax:614-326-3509
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2015-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN