Healthcare Provider Details

I. General information

NPI: 1497511034
Provider Name (Legal Business Name): FAMILY FEEDING CONNECTIONS: LACTATION AND FEEDING THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2024
Last Update Date: 02/21/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 BROOKHOLLOW LN
JOHNS CREEK GA
30022-7305
US

IV. Provider business mailing address

410 BROOKHOLLOW LN
JOHNS CREEK GA
30022-7305
US

V. Phone/Fax

Practice location:
  • Phone: 404-368-0721
  • Fax:
Mailing address:
  • Phone: 404-368-0721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JESSICA ORLICK
Title or Position: OWNER
Credential: MS, CCC-SLP, IBCLC
Phone: 404-368-0721