Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | 11095444 | GA |
NPI | 1215275540 |
---|---|
Provider Name | Ms. Janet Donnelly Carraway |
First Address | Milton, GA 30004-3508 |
Second Address | Milton, GA 30004-3508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2013 |
Last Update Date | 02/10/2015 |