Provider Demographics
NPI:1487439196
Name:ARKANSAS BREASTFEEDING CLINIC LLC
Entity type:Organization
Organization Name:ARKANSAS BREASTFEEDING CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SONDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODOCKER
Authorized Official - Suffix:
Authorized Official - Credentials:IBCLC
Authorized Official - Phone:501-491-0521
Mailing Address - Street 1:200 COPPER WAY
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-4038
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10825 KANIS RD STE 300
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3802
Practice Address - Country:US
Practice Address - Phone:501-491-0521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty