Provider Demographics
NPI:1811699473
Name:HARRISON, ALLISON BRYANE (CLC, MILC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:BRYANE
Last Name:HARRISON
Suffix:
Gender:F
Credentials:CLC, MILC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 LACEY LN
Mailing Address - Street 2:
Mailing Address - City:ANACOCO
Mailing Address - State:LA
Mailing Address - Zip Code:71403-3267
Mailing Address - Country:US
Mailing Address - Phone:337-509-0261
Mailing Address - Fax:
Practice Address - Street 1:157 LACEY LN
Practice Address - Street 2:
Practice Address - City:ANACOCO
Practice Address - State:LA
Practice Address - Zip Code:71403-3267
Practice Address - Country:US
Practice Address - Phone:337-509-0261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
345264174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN