Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant |
NPI | 1104275759 |
---|---|
Provider Name | Molly Parker |
First Address | Atlanta, GA 30328-2155 |
Second Address | Atlanta, GA 30339-5011 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2016 |
Last Update Date | 05/06/2016 |