Provider Demographics
NPI:1760846349
Name:HALEK, CATHERINE (IBCLC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:HALEK
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 1:7736A 62ND ST N
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3209
Mailing Address - Country:US
Mailing Address - Phone:727-231-4670
Mailing Address - Fax:
Practice Address - Street 1:7736A 62ND ST N
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3209
Practice Address - Country:US
Practice Address - Phone:727-231-4670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLL-87915174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLL-87915OtherINTERNATIONAL BOARD CERTIFIED LACTATION CONSULTANT