Organization
MOTHER'S MAGICAL MILK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TENISE HORDGE IBCLC (OWNER, OPERATOR)
(817) 405-9661
Entity
Organization
Contact information
Practice address
1015 E DALLAS ST STE 2, MANSFIELD, TX 76063-2029
(817) 405-9661
Mailing address
4602 SPRING LAKE PKWY, MANSFIELD, TX 76063-5590
(480) 215-9077
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
03/02/2023
Last updated
03/02/2023
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