Organization
NICHOLE MCCLOY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLE MCCLOY RN IBCLC (OWNER)
(303) 960-2422
Entity
Organization
Contact information
Practice address
12432 MORRIS DIDO NEWARK RD, FORT WORTH, TX 76179-9206
(303) 960-2422
Mailing address
12432 MORRIS DIDO NEWARK RD, FORT WORTH, TX 76179-9206
(303) 960-2422
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
—
—
163WM0102X
Maternal Newborn Registered Nurse
—
—
174N00000X
Lactation Consultant (Non-RN)
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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