Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | L-302590 | GA |
N | 225700000X | Massage Therapist | MT006471 | GA |
NPI | 1316507445 |
---|---|
Provider Name | Mckale Ashley Fleming |
First Address | Bainbridge, GA 39818-7474 |
Second Address | Bainbridge, GA 39817-8090 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2019 |
Last Update Date | 06/10/2021 |