Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | 000184 | GA |
NPI | 1114289097 |
---|---|
Provider Name | Jessica Melito Orlick |
First Address | Johns Creek, GA 30022-7305 |
Second Address | Johns Creek, GA 30022-7305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2012 |
Last Update Date | 06/05/2020 |