Healthcare Provider Details

I. General information

NPI: 1972296903
Provider Name (Legal Business Name): FRUITS OF LABOR: CHILDBIRTH EDUCATION AND BREASTFEEDING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2023
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 FREEMAN CIR
VILLA RICA GA
30180-7085
US

IV. Provider business mailing address

304 FREEMAN CIR
VILLA RICA GA
30180-7085
US

V. Phone/Fax

Practice location:
  • Phone: 404-834-3174
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: MRS. DESTINY OLIVEA SAUCEDO
Title or Position: OWNER/ FOUNDER
Credential: CLC, CCE
Phone: 404-834-3174