Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Stephanie Ann Bodak Nicholson, IBCLC

Individual provider Lactation Consultant (Non-RN) · NPI 1407503717

Stephanie Ann Bodak Nicholson, IBCLC is a Lactation Consultant (Non-RN) in Moody, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2022

Practice location Address checks out

15047 Dove Rd
Moody, TX 76557-3160
Phone: (254) 913-6939
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Lactation Consultant (Non-RN) (primary) Taxonomy 174N00000X · Licence L-301558 (TX)

Record details

NPI number1407503717
Entity typeIndividual (Type 1)
GenderFemale
Credentials IBCLC
Sole proprietorYes
NPI enumeratedMarch 7, 2022
Last updated in NPPESMarch 7, 2022
Certification dateMarch 7, 2022