Provider Demographics
NPI:1801690086
Name:BAUCH, BOBBY-JEAN KAY (IBCLC)
Entity type:Individual
Prefix:
First Name:BOBBY-JEAN
Middle Name:KAY
Last Name:BAUCH
Suffix:
Gender:
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7708 RICHMOND HWY # 1089
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22306-2803
Mailing Address - Country:US
Mailing Address - Phone:760-576-8827
Mailing Address - Fax:
Practice Address - Street 1:7708 RICHMOND HWY # 1089
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306-2803
Practice Address - Country:US
Practice Address - Phone:760-576-8827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL313048174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN