Provider Demographics
NPI:1831952142
Name:KATHYS BREASTFEEDING NOOK
Entity type:Organization
Organization Name:KATHYS BREASTFEEDING NOOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LACTATION CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:GAUTHIER
Authorized Official - Suffix:
Authorized Official - Credentials:CNM,IBCLC
Authorized Official - Phone:860-705-5663
Mailing Address - Street 1:12 COOGAN BLVD STE 204
Mailing Address - Street 2:
Mailing Address - City:MYSTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06355-1938
Mailing Address - Country:US
Mailing Address - Phone:860-705-5663
Mailing Address - Fax:
Practice Address - Street 1:12 COOGAN BLVD STE 204
Practice Address - Street 2:
Practice Address - City:MYSTIC
Practice Address - State:CT
Practice Address - Zip Code:06355-1938
Practice Address - Country:US
Practice Address - Phone:860-705-5663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty