# LACTATION CONNECTION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104153212
- **Authorized official:** TANYA R ROBERTS IBCLC (OWNER)
- **Authorized official phone:** (254) 728-3627

## Contact information

- **Practice address:** 15036 COUNTY ROAD 156, BLUFF DALE, TX 76433-3560
- **Practice address phone:** (254) 728-3627
- **Practice address fax:** (254) 728-3626
- **Mailing address:** PO BOX 265, BLUFF DALE, TX 76433-0265
- **Mailing address phone:** (254) 728-3627
- **Mailing address fax:** (254) 728-3626

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 11/10/2009
- **Last updated:** 11/10/2009