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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

STEPHANIE ANN BODAK NICHOLSON, IBCLC

Active Sole Proprietor

STEPHANIE ANN BODAK NICHOLSON, IBCLC is a Lactation Consultant healthcare provider located in MOODY, Texas. NPI 1407503717 is currently active in the NPPES registry. Verify at CMS.

Lactation Consultant · MOODY, TX

Registration Details

NPI Number
1407503717
Provider Type
Individual
Gender
Female
NPI Issued
Mar 7, 2022 (4.4023863561246 yrs)
Last Updated
Mar 7, 2022
License
L-301558 (TX)
Sole Proprietor
Yes

Practice Information

Address
15047 DOVE RD
MOODY, TX, 765573160
Browse TX providers · Browse ZIP 76557
Phone
2549136939
Primary Specialty
Lactation Consultant
174N00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.