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General NPI Number Information
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NPI Number | 1063905594
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Entity Type | Organization
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Legal Business Name | ATLANTA LACTATION
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Dates
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Enumeration Date | 06/09/2018
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Last Update Date | 06/09/2018
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Provider Practice Location Address
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Address Line | 622 KIMBERLY LN NE
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City | ATLANTA
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State | GA
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Zip | 30306-2225
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Country | US
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Telephone | 404-281-1662
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Fax | 404-481-2026
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Provider Business Mailing Address
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Address Line | 622 KIMBERLY LN NE
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City | ATLANTA
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State | GA
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Zip | 30306-2225
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Country | US
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Telephone | 404-281-1662
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Fax | 404-481-2026
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Authorized Official
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Title or Position | OWNER
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Name | KATHERINE MORRISON
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Credential | IBCLC
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Telephone | 404-281-1662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | L-000054
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License Number State | GA
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