Individual
MRS. THERESA MARIE HAILS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
316 OLD ROUTE 6 RD, LACEYVILLE, PA 18623-6714
(570) 954-5835
Mailing address
316 OLD ROUTE 6 RD, LACEYVILLE, PA 18623-6714
(570) 954-5835
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
L-142583
PA
Other
Enumeration date
08/10/2021
Last updated
08/10/2021
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