Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1083963326 |
---|---|
Provider Name | Lucia Massey |
First Address | Athens, GA 30601-3804 |
Second Address | Athens, GA 30601-3804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2012 |
Last Update Date | 31/08/2012 |