Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 174N00000X | Lactation Consultant | LD004058 | GA |
NPI | 1326479262 |
---|---|
Provider Name | Ms. Lori Ann Scholle |
First Address | Decatur, GA 30031-1623 |
Second Address | Decatur, GA 30030-5108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2013 |
Last Update Date | 03/12/2013 |