Provider Demographics
NPI:1770396533
Name:TEARE, ASHLEY (IBCLC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:TEARE
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 1:101 OAK RUN
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-8615
Mailing Address - Country:US
Mailing Address - Phone:509-592-0857
Mailing Address - Fax:
Practice Address - Street 1:101 OAK RUN
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8615
Practice Address - Country:US
Practice Address - Phone:509-592-0857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
L-301418174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty